Provider Demographics
NPI:1659988475
Name:CENTRAL SPEECH THERAPY
Entity Type:Organization
Organization Name:CENTRAL SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER, SPEECH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:978-212-9616
Mailing Address - Street 1:285 CENTRAL ST STE 217B
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-6144
Mailing Address - Country:US
Mailing Address - Phone:978-212-9616
Mailing Address - Fax:978-849-8393
Practice Address - Street 1:285 CENTRAL ST STE 217B
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-6144
Practice Address - Country:US
Practice Address - Phone:978-212-9616
Practice Address - Fax:978-849-8393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-25
Last Update Date:2020-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty