Provider Demographics
NPI:1740597350
Name:0NE STOP SPEECH AND LANGUAGE THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:0NE STOP SPEECH AND LANGUAGE THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MS CCC SLP
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:SPEECH PATHOLOGIST
Authorized Official - Phone:347-277-6014
Mailing Address - Street 1:7608 AQUATIC DR
Mailing Address - Street 2:
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-2015
Mailing Address - Country:US
Mailing Address - Phone:347-277-6014
Mailing Address - Fax:718-554-7486
Practice Address - Street 1:7608 AQUATIC DR
Practice Address - Street 2:
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-2015
Practice Address - Country:US
Practice Address - Phone:347-277-6014
Practice Address - Fax:718-554-7486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty