Provider Demographics
NPI:1609127190
Name:ENGAGING COMMUNICATION SPEECH LANGUAGE THERAPY
Entity Type:Organization
Organization Name:ENGAGING COMMUNICATION SPEECH LANGUAGE THERAPY
Other - Org Name:ENGAGING COMMUNICATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDI
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP
Authorized Official - Phone:718-490-6095
Mailing Address - Street 1:19 FERN AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308-2225
Mailing Address - Country:US
Mailing Address - Phone:718-490-6095
Mailing Address - Fax:
Practice Address - Street 1:19 FERN AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10308-2225
Practice Address - Country:US
Practice Address - Phone:718-490-6095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7760737261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech