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General NPI Number Information
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NPI Number | 1134438583
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Entity Type | Organization
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Legal Business Name | SPEECH, LANGUAGE, AND COMMUNICATION ASSOCIATES
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Dates
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Enumeration Date | 10/04/2010
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Last Update Date | 10/04/2010
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Provider Practice Location Address
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Address Line | 5544 MAIN STREET SPEECH, LANGUAGE, AND COMMUNICATION ASSOCIATES
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221
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Country | US
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Telephone | 716-580-3976
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Fax | 716-580-3978
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Provider Business Mailing Address
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Address Line | 5544 MAIN STREET SPEECH, LANGUAGE, AND COMMUNICATION ASSOCIATES
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221
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Country | US
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Telephone | 716-580-3976
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Fax | 716-580-3978
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Authorized Official
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Title or Position | OWNER, DIRECTOR
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Name | MS. TAMI TRAUTLEIN
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Credential | MS, CCC-SLP
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Telephone | 716-580-3976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 004661
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License Number State | NY
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