Provider Demographics
NPI:1689961690
Name:CHATTY CHILD SPEECH THERAPY, PLLC
Entity Type:Organization
Organization Name:CHATTY CHILD SPEECH THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOERNER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:917-776-1585
Mailing Address - Street 1:307 6TH ST
Mailing Address - Street 2:FLOOR 3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3205
Mailing Address - Country:US
Mailing Address - Phone:917-776-1585
Mailing Address - Fax:
Practice Address - Street 1:350 BROADWAY
Practice Address - Street 2:SUITE 905
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3911
Practice Address - Country:US
Practice Address - Phone:347-491-4451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015262-1251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services