MEDICARE: ALL 4 THERAPY

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	:	1588383483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL 4 THERAPY

Provider Business Mailing Address
First Line	:	200 WANAQUE AVE STE 302
Second Line	:
City	:	POMPTON LAKES
State	:	NJ
Zip	:	07442-2130
Country	:	US
Telephone Number	:	862-666-1692
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 WANAQUE AVE STE 302
Second Line	:
City	:	POMPTON LAKES
State	:	NJ
Zip	:	07442-2130
Country	:	US
Telephone Number	:	862-666-1692
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGUAGE PATHOLOGIST
Name	:	MRS. MARIE-ANGE MALYAROVICH
Credential	:	MA
Telephone Number	:	201-410-3979

Provider Enumeration Date	:	08/24/2022
Last Update Date	:	10/04/2023

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Directions to “ALL 4 THERAPY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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