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General NPI Number Information
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NPI Number | 1023720281
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Entity Type | Organization
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Legal Business Name | SPEECH SUCCESS
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Dates
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Enumeration Date | 12/20/2022
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Last Update Date | 12/20/2022
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Provider Practice Location Address
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Address Line | 12 LINCOLN BLVD STE 103
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City | EMERSON
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State | NJ
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Zip | 07630-1173
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Country | US
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Telephone | 201-247-2696
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Fax |
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Provider Business Mailing Address
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Address Line | 885 ORADELL AVE
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City | ORADELL
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State | NJ
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Zip | 07649-1924
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Country | US
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Telephone | 201-247-2696
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF SPEECH-LANGUAGE PATHOLOGY
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Name | DR. JACQUELINE AHRENS
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Credential | SLPD
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Telephone | 201-247-2696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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