Provider Demographics
NPI: | 1881904498 |
---|---|
Name: | SPED CONSULTING & THERAPY |
Entity type: | Organization |
Organization Name: | SPED CONSULTING & THERAPY |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | AGENCY OWNER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | MICHELE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MANN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 570-656-4047 |
Mailing Address - Street 1: | PO BOX 961 |
Mailing Address - Street 2: | |
Mailing Address - City: | EFFORT |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 18330-0961 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 570-656-4047 |
Mailing Address - Fax: | 570-871-3775 |
Practice Address - Street 1: | 1002 FAWN CT |
Practice Address - Street 2: | |
Practice Address - City: | EFFORT |
Practice Address - State: | PA |
Practice Address - Zip Code: | 18330-8604 |
Practice Address - Country: | US |
Practice Address - Phone: | 570-656-4047 |
Practice Address - Fax: | 570-871-3775 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-10-15 |
Last Update Date: | 2011-03-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 252Y00000X | Agencies | Early Intervention Provider Agency | ||
No | 136A00000X | Dietary & Nutritional Service Providers | Dietetic Technician, Registered | Group - Multi-Specialty | |
No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
No | 133VN1004X | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Pediatric | Group - Multi-Specialty |
No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | Group - Multi-Specialty | |
No | 133NN1002X | Dietary & Nutritional Service Providers | Nutritionist | Nutrition, Education | Group - Multi-Specialty |
No | 163W00000X | Nursing Service Providers | Registered Nurse | Group - Multi-Specialty | |
No | 163WN1003X | Nursing Service Providers | Registered Nurse | Nutrition Support | Group - Multi-Specialty |
No | 163WP0200X | Nursing Service Providers | Registered Nurse | Pediatrics | Group - Multi-Specialty |
No | 164W00000X | Nursing Service Providers | Licensed Practical Nurse | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |