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General NPI Number Information
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NPI Number | 1023305240
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Entity Type | Organization
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Legal Business Name | EAT SPEAK PLAY
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Dates
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Enumeration Date | 07/08/2011
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 46 MOUNT VERNON AVE
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City | ALEXANDRIA
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State | VA
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Zip | 22301-2321
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Country | US
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Telephone | 703-828-7570
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Fax |
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Provider Business Mailing Address
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Address Line | 46 MOUNT VERNON AVE
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City | ALEXANDRIA
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State | VA
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Zip | 22301-2321
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Country | US
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Telephone | 703-828-7570
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | DEBORAH PERRY
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Credential | MSR, CCC-SLP, ATP
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Telephone | 703-828-7570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | SLP00189
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License Number State | DC
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