Provider Demographics
NPI:1831660141
Name:MARIA SPANOS SPEECH LANGUAGE PATHOLOGIST PC
Entity Type:Organization
Organization Name:MARIA SPANOS SPEECH LANGUAGE PATHOLOGIST PC
Other - Org Name:BABES IN SPEECHLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPANOS
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:917-434-3262
Mailing Address - Street 1:7162 244TH ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1947
Mailing Address - Country:US
Mailing Address - Phone:917-434-3262
Mailing Address - Fax:
Practice Address - Street 1:7162 244TH ST
Practice Address - Street 2:
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11362-1947
Practice Address - Country:US
Practice Address - Phone:917-434-3262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-12
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency