Provider Demographics
NPI:1669843736
Name:FIRST STAGES FEEDING SPECIALISTS, LLC
Entity Type:Organization
Organization Name:FIRST STAGES FEEDING SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PRESBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:703-901-7277
Mailing Address - Street 1:12508 ARNSLEY CT
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-2538
Mailing Address - Country:US
Mailing Address - Phone:703-901-7277
Mailing Address - Fax:703-373-8785
Practice Address - Street 1:12508 ARNSLEY CT
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-2538
Practice Address - Country:US
Practice Address - Phone:703-901-7277
Practice Address - Fax:703-373-8785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-14
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202003410235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty