Provider Demographics
NPI:1821871740
Name:WORDWISE SPEECH THERAPY FOUNDATION, INC.
Entity Type:Organization
Organization Name:WORDWISE SPEECH THERAPY FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIANNINO
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:631-365-1504
Mailing Address - Street 1:375 COMMACK RD STE 211
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-5515
Mailing Address - Country:US
Mailing Address - Phone:631-365-1504
Mailing Address - Fax:
Practice Address - Street 1:375 COMMACK RD STE 211
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-5515
Practice Address - Country:US
Practice Address - Phone:631-365-1504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty