Provider Demographics
NPI:1568710564
Name:SLP SERVICES OF SOUTH JERSEY LLC
Entity Type:Organization
Organization Name:SLP SERVICES OF SOUTH JERSEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCUS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:609-579-6101
Mailing Address - Street 1:1565 HANCE BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-1211
Mailing Address - Country:US
Mailing Address - Phone:609-579-6101
Mailing Address - Fax:
Practice Address - Street 1:1565 HANCE BRIDGE RD
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-1211
Practice Address - Country:US
Practice Address - Phone:609-579-6101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-22
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health