Provider Demographics
NPI:1912236399
Name:SPEAK YOUR MIND, SPEECH PATHOLOGY SERVIES
Entity Type:Organization
Organization Name:SPEAK YOUR MIND, SPEECH PATHOLOGY SERVIES
Other - Org Name:SPEAK YOUR MIND, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH PATHOLOGIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRSCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC/SLP
Authorized Official - Phone:973-328-2376
Mailing Address - Street 1:93 MOUNTAINSIDE DR
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2309
Mailing Address - Country:US
Mailing Address - Phone:973-328-2376
Mailing Address - Fax:973-328-2376
Practice Address - Street 1:93 MOUNTAINSIDE DR
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-2309
Practice Address - Country:US
Practice Address - Phone:973-328-2376
Practice Address - Fax:973-328-2376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00424000235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty