Provider Demographics
NPI:1922737659
Name:VOICEOVER SPEECH PATHOLOGY SERVICES
Entity Type:Organization
Organization Name:VOICEOVER SPEECH PATHOLOGY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:GERRIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:585-415-8456
Mailing Address - Street 1:3177 LATTA ROAD
Mailing Address - Street 2:217 VOICEOVER
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612
Mailing Address - Country:US
Mailing Address - Phone:585-415-8456
Mailing Address - Fax:844-206-1040
Practice Address - Street 1:3177 LATTA ROAD
Practice Address - Street 2:217 VOICEOVER
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612
Practice Address - Country:US
Practice Address - Phone:585-415-8456
Practice Address - Fax:844-206-1040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty