Provider Demographics
NPI:1598208407
Name:SPEECH & RESOURCE GROUP, INC
Entity Type:Organization
Organization Name:SPEECH & RESOURCE GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIANA
Authorized Official - Middle Name:INES
Authorized Official - Last Name:DE DONATIS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:518-779-9448
Mailing Address - Street 1:3300 NE 192ND ST
Mailing Address - Street 2:505
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2427
Mailing Address - Country:US
Mailing Address - Phone:518-779-9448
Mailing Address - Fax:
Practice Address - Street 1:3300 NE 192ND ST
Practice Address - Street 2:505
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2427
Practice Address - Country:US
Practice Address - Phone:518-779-9448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-24
Last Update Date:2016-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA10961235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty