Healthcare Provider Details

I. General information

NPI: 1407778095
Provider Name (Legal Business Name): THE SPEECH AND LANGUAGE PRACTICE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 PATCHEN AVE APT 3
BROOKLYN NY
11233-1907
US

IV. Provider business mailing address

248 PATCHEN AVE APT 3
BROOKLYN NY
11233-1907
US

V. Phone/Fax

Practice location:
  • Phone: 845-500-3723
  • Fax:
Mailing address:
  • Phone: 845-500-3723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. IZABELLA NORAE BARTOLOME
Title or Position: CCC-SLP
Credential: MS
Phone: 845-500-3723