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General NPI Number Information
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NPI Number | 1215185533
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Entity Type | Organization
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Legal Business Name | CONSULTATION-INTERVENTION INC.
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 08/28/2008
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Provider Practice Location Address
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Address Line | 21245 26TH AVE
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City | BAYSIDE
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State | NY
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Zip | 11360-1901
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Country | US
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Telephone | 917-355-5060
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Fax | 718-224-0103
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Provider Business Mailing Address
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Address Line | 4206A BELL BLVD STE 250
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City | BAYSIDE
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State | NY
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Zip | 11361-2862
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Country | US
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Telephone | 917-355-5060
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Fax | 718-224-0103
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Authorized Official
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Title or Position | PRESIDENT, CEO, SPEECH LANG. PATH.
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Name | MS. LESLIE A. GRUBLER
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Credential | MA, CCC-SLP, TSHH
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Telephone | 917-355-5060
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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 | 010959-1
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License Number State | NY
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