Provider Demographics
NPI:1932405396
Name:SMALL BITE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:SMALL BITE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:JACOBSON
Authorized Official - Last Name:BORJA
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC/SLP
Authorized Official - Phone:973-452-1569
Mailing Address - Street 1:113 S PEMBERTON AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07757-1011
Mailing Address - Country:US
Mailing Address - Phone:973-452-1569
Mailing Address - Fax:
Practice Address - Street 1:113 S PEMBERTON AVE
Practice Address - Street 2:
Practice Address - City:OCEANPORT
Practice Address - State:NJ
Practice Address - Zip Code:07757-1011
Practice Address - Country:US
Practice Address - Phone:732-544-1529
Practice Address - Fax:732-544-1529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00318600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty