Provider Demographics
NPI:1790226199
Name:THERAP KIDS SLP INC.
Entity Type:Organization
Organization Name:THERAP KIDS SLP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ENID
Authorized Official - Middle Name:MAITE
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:954-612-7771
Mailing Address - Street 1:PO BOX 824636
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33082-4636
Mailing Address - Country:US
Mailing Address - Phone:954-612-7771
Mailing Address - Fax:786-482-8356
Practice Address - Street 1:30054 SW 158TH CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-3448
Practice Address - Country:US
Practice Address - Phone:954-612-7771
Practice Address - Fax:786-482-8356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-17
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA13661235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty