Provider Demographics
NPI:1750049938
Name:WORDS OF WISDOM SPEECH & LANGUAGE THERAPY
Entity Type:Organization
Organization Name:WORDS OF WISDOM SPEECH & LANGUAGE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ATHENA
Authorized Official - Middle Name:
Authorized Official - Last Name:STAGIAS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP, TSSLD
Authorized Official - Phone:610-349-4505
Mailing Address - Street 1:2388 31ST ST APT 5C
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-3327
Mailing Address - Country:US
Mailing Address - Phone:610-349-4505
Mailing Address - Fax:
Practice Address - Street 1:2388 31ST ST APT 5C
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-3327
Practice Address - Country:US
Practice Address - Phone:610-349-4505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech