Provider Demographics
NPI:1598168346
Name:EXPRESS COMMUNICATION THERAPY/COMUNICATE CONMIGO THERAPY, PLLC
Entity Type:Organization
Organization Name:EXPRESS COMMUNICATION THERAPY/COMUNICATE CONMIGO THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH AND LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANA MARIA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:RENDON
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:201-921-1956
Mailing Address - Street 1:226 JULIAN POND LANE
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:226 JULIAN POND LN
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-2461
Practice Address - Country:US
Practice Address - Phone:201-921-1956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9370252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency