Provider Demographics
NPI:1740937242
Name:JS BILINGUAL SPEECH THERAPY CENTER CORP
Entity type:Organization
Organization Name:JS BILINGUAL SPEECH THERAPY CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPY ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:DESVY
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-837-1909
Mailing Address - Street 1:16431 BLATT BLVD APT 104
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1841
Mailing Address - Country:US
Mailing Address - Phone:754-837-1909
Mailing Address - Fax:
Practice Address - Street 1:16431 BLATT BLVD APT 104
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-1841
Practice Address - Country:US
Practice Address - Phone:754-837-1909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty