Healthcare Provider Details

I. General information

NPI: 1538098728
Provider Name (Legal Business Name): SPEAKHAUS THERAPY AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 NATIONAL BLVD
LONG BEACH NY
11561-2014
US

IV. Provider business mailing address

518 NATIONAL BLVD
LONG BEACH NY
11561-2014
US

V. Phone/Fax

Practice location:
  • Phone: 516-425-3464
  • Fax:
Mailing address:
  • Phone: 516-425-3464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MISS TIANA ALEXIS RODRIGUEZ
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: M.S., CCC-SLP
Phone: 516-425-3464