Provider Demographics
NPI:1578200408
Name:SPEECH N PLAY THERAPY GROUP
Entity Type:Organization
Organization Name:SPEECH N PLAY THERAPY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:CASTRO RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-273-7555
Mailing Address - Street 1:HCDA TOLEDO 273 BLVD DE TOLEDO
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:939-273-7555
Mailing Address - Fax:
Practice Address - Street 1:BO. CARRIZALES
Practice Address - Street 2:CARR 493 KM 0.9 LOCAL #4
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:939-273-7555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1912463464Medicaid