Provider Demographics
NPI:1881216687
Name:CONNECTPATHWAYS SPEECH & LANGUAGE CENTER LLC
Entity Type:Organization
Organization Name:CONNECTPATHWAYS SPEECH & LANGUAGE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:C
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:609-306-6168
Mailing Address - Street 1:1 FORSGATE LN
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-2709
Mailing Address - Country:US
Mailing Address - Phone:609-306-6168
Mailing Address - Fax:
Practice Address - Street 1:1540 KUSER RD STE A2
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3828
Practice Address - Country:US
Practice Address - Phone:609-306-6168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty