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General NPI Number Information
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NPI Number | 1225258403
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Entity Type | Organization
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Legal Business Name | CENTER FOR SPEECH AND MOVEMENT
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 24 DAVIS ROAD
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City | LAKEWOOD
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State | NJ
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Zip | 08701
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Country | US
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Telephone | 732-363-1992
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Fax | 732-370-1973
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Provider Business Mailing Address
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Address Line | 24 DAVIS ROAD
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City | LAKEWOOD
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State | NJ
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Zip | 08701
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Country | US
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Telephone | 732-363-1992
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Fax | 732-370-1973
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Authorized Official
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Title or Position | DIRECTOR CENTER FOR SPEECH AND MOVE
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Name | RUTH FREUNDLICH
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Credential |
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Telephone | 732-363-1992
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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 | YS01112
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License Number State | NJ
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