Provider Demographics
NPI:1134799513
Name:EARLY SUCCESS SPEECH THERAPY PC
Entity type:Organization
Organization Name:EARLY SUCCESS SPEECH THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUBA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP, TSHH
Authorized Official - Phone:347-512-0100
Mailing Address - Street 1:54 HAAS RD
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-2670
Mailing Address - Country:US
Mailing Address - Phone:347-512-0100
Mailing Address - Fax:
Practice Address - Street 1:54 HAAS RD
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-2670
Practice Address - Country:US
Practice Address - Phone:347-512-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty