Provider Demographics
NPI:1538519053
Name:SPEECH SKILLS GROUP
Entity Type:Organization
Organization Name:SPEECH SKILLS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMYELA
Authorized Official - Middle Name:P
Authorized Official - Last Name:SEGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-247-1368
Mailing Address - Street 1:46 SAINT NICHOLAS AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3005
Mailing Address - Country:US
Mailing Address - Phone:908-247-1368
Mailing Address - Fax:732-415-4415
Practice Address - Street 1:46 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3005
Practice Address - Country:US
Practice Address - Phone:908-247-1368
Practice Address - Fax:732-415-4415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty