Provider Demographics
NPI:1952069353
Name:SPEAK-EAT-SMILE THERAPY
Entity Type:Organization
Organization Name:SPEAK-EAT-SMILE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAVANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:917-601-6488
Mailing Address - Street 1:444 WASHINGTON BLVD APT 5328
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310-1905
Mailing Address - Country:US
Mailing Address - Phone:917-601-6488
Mailing Address - Fax:
Practice Address - Street 1:444 WASHINGTON BLVD APT 5328
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07310-1905
Practice Address - Country:US
Practice Address - Phone:917-601-6488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty