Healthcare Provider Details

I. General information

NPI: 1568243905
Provider Name (Legal Business Name): PLYMOUTH SPEECH THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2023
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 WHEELWRIGHT LN
CHERRY HILL NJ
08003-1441
US

IV. Provider business mailing address

9 WHEELWRIGHT LN
CHERRY HILL NJ
08003-1441
US

V. Phone/Fax

Practice location:
  • Phone: 856-651-8695
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE HOLROYD
Title or Position: OWNER
Credential:
Phone: 856-651-8695