Healthcare Provider Details

I. General information

NPI: 1720357551
Provider Name (Legal Business Name): CREATIVE SPEECH SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2011
Last Update Date: 12/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 SUMMIT AVE
SUMMIT NJ
07901-2813
US

IV. Provider business mailing address

151 SUMMIT AVE
SUMMIT NJ
07901-2813
US

V. Phone/Fax

Practice location:
  • Phone: 908-598-0228
  • Fax: 908-598-0175
Mailing address:
  • Phone: 908-598-0228
  • Fax: 908-598-0175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number005045-1
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number46TR00383900
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number46TR00339900
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number46TR00471600
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number46TR00521300
License Number StateNJ

VIII. Authorized Official

Name: CYNTHIA MARRAPODI
Title or Position: DIRECTOR/OWNER
Credential:
Phone: 908-598-0228