Healthcare Provider Details

I. General information

NPI: 1922592393
Provider Name (Legal Business Name): TENDER LOVING CARE SPEECH THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2018
Last Update Date: 07/09/2020
Certification Date: 07/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 RED OAK LANE
SPRING VALLEY NY
10977
US

IV. Provider business mailing address

2 RED OAK LN
SPRING VALLEY NY
10977-1205
US

V. Phone/Fax

Practice location:
  • Phone: 845-323-1919
  • Fax:
Mailing address:
  • Phone: 845-323-1919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number026255
License Number StateNY

VIII. Authorized Official

Name: MIRIAM KATZ
Title or Position: SLP
Credential: MA, CCC-SLP
Phone: 845-323-1919