Provider Demographics
NPI:1609269133
Name:BEBE MARIN SPEECH THERAPY LLC
Entity Type:Organization
Organization Name:BEBE MARIN SPEECH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BEATRIZ
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:MARIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS/CCC-SLP
Authorized Official - Phone:814-882-0761
Mailing Address - Street 1:8110 SIMIT LANE
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:PA
Mailing Address - Zip Code:16417
Mailing Address - Country:US
Mailing Address - Phone:814-474-5324
Mailing Address - Fax:
Practice Address - Street 1:8110 SIMIT LN
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:PA
Practice Address - Zip Code:16417-8759
Practice Address - Country:US
Practice Address - Phone:814-474-5324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL002826L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty