MEDICARE: SPEECH AND COMMUNICATION LEADERS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1124593447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPEECH AND COMMUNICATION LEADERS, LLC

Provider Business Mailing Address
First Line	:	1645 BARRYMOR DR
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-3905
Country	:	US
Telephone Number	:	845-521-2633
Fax Number	:	732-364-3401

Provider Business Practice Location Address
First Line	:	1645 BARRYMOR DR
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-3905
Country	:	US
Telephone Number	:	845-521-2633
Fax Number	:	732-364-3401

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST/EMPLOYE
Name	:	NAOMI A SOCHACZEWSKI
Credential	:	M.S. CCC-SLP
Telephone Number	:	845-521-2633

Provider Enumeration Date	:	10/13/2018
Last Update Date	:	10/13/2018

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Directions to “SPEECH AND COMMUNICATION LEADERS, LLC ” Practice Location

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