Healthcare Provider Details
I. General information
NPI: 1750742409
Provider Name (Legal Business Name): SENSORY SPEECH AND SOCIALIZATION ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/09/2016
Last Update Date: 03/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
242 WASHINGTON AVE OFC J
NUTLEY NJ
07110-3934
US
IV. Provider business mailing address
242 WASHINGTON AVE OFC J
NUTLEY NJ
07110-3934
US
V. Phone/Fax
- Phone: 888-627-5578
- Fax:
- Phone: 888-627-5578
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
ROSA
ALLOWAY
Title or Position: CEO
Credential: MSW
Phone: 888-627-5578