Healthcare Provider Details

I. General information

NPI: 1306752530
Provider Name (Legal Business Name): JUST SPEECHY SPEECH LANGUAGE AND FEEDING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8007 HOLLIS HILLS TER
QUEENS VILLAGE NY
11427-1016
US

IV. Provider business mailing address

8007 HOLLIS HILLS TER
QUEENS VILLAGE NY
11427-1016
US

V. Phone/Fax

Practice location:
  • Phone: 917-742-4785
  • Fax:
Mailing address:
  • Phone: 917-742-4785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DIANA SHIMONOVA
Title or Position: SPEECH LANGUAGE PATHOLOGIST/OWNER
Credential: MS, CCC-SLP
Phone: 917-742-4785