Provider Demographics
NPI:1013505502
Name:HALIE GARBER SPEECH THERAPY PLLC
Entity Type:Organization
Organization Name:HALIE GARBER SPEECH THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:HALIE
Authorized Official - Middle Name:LAUREN
Authorized Official - Last Name:GARBER
Authorized Official - Suffix:
Authorized Official - Credentials:MA,CCC-SLP
Authorized Official - Phone:347-463-0215
Mailing Address - Street 1:253 LORETTO ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10307-1986
Mailing Address - Country:US
Mailing Address - Phone:347-463-0215
Mailing Address - Fax:
Practice Address - Street 1:253 LORETTO ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10307-1986
Practice Address - Country:US
Practice Address - Phone:347-463-0215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-09
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05379460Medicaid