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General NPI Number Information
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NPI Number | 1033683503
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Entity Type | Organization
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Legal Business Name | SPEECH BUNNY, PC
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Dates
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Enumeration Date | 01/17/2019
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Last Update Date | 01/17/2019
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Provider Practice Location Address
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Address Line | 180 FRANKLIN AVE APT 219
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City | BROOKLYN
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State | NY
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Zip | 11205-2187
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Country | US
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Telephone | 347-787-2775
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 50135
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City | BROOKLYN
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State | NY
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Zip | 11205-0135
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Country | US
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Telephone | 347-787-2775
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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 | SHANTE HASKINS
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Credential |
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Telephone | 347-247-9754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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