Provider Demographics
NPI:1568441848
Name:BOLLMAN BEHAVIOR & SPEECH SERVICES, INC.
Entity Type:Organization
Organization Name:BOLLMAN BEHAVIOR & SPEECH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DESIMONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-761-1485
Mailing Address - Street 1:705 CHATSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15202-2235
Mailing Address - Country:US
Mailing Address - Phone:412-761-1485
Mailing Address - Fax:412-761-1486
Practice Address - Street 1:705 CHATSWORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15202-2235
Practice Address - Country:US
Practice Address - Phone:412-761-1485
Practice Address - Fax:412-761-1486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101286620 0001Medicaid
PA=========OtherUNITED