MEDICARE: INTERACT SPEECH THERAPY, 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	:	1821860123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERACT SPEECH THERAPY, LLC

Provider Business Mailing Address
First Line	:	59 DEER HILL RD
Second Line	:
City	:	REDDING
State	:	CT
Zip	:	06896-2312
Country	:	US
Telephone Number	:	203-993-5711
Fax Number	:

Provider Business Practice Location Address
First Line	:	59 DEER HILL RD
Second Line	:
City	:	REDDING
State	:	CT
Zip	:	06896-2312
Country	:	US
Telephone Number	:	203-993-5711
Fax Number	:

Authorized Official
Title or Position	:	OWNER/SLP
Name	:	LIZ DESANTIS CORREA
Credential	:
Telephone Number	:	203-993-5711

Provider Enumeration Date	:	10/30/2023
Last Update Date	:	10/30/2023

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Directions to “INTERACT SPEECH THERAPY, LLC ” Practice Location

Language	Start Address	Practice Location

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