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General NPI Number Information
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NPI Number | 1225267610
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Entity Type | Organization
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Legal Business Name | CLASS (CHILDREN'S LANGUAGE AND SPEECH SERVICES), LLC.
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 07/07/2009
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Provider Practice Location Address
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Address Line | 250 5TH AVE SUITE 210
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City | NEW YORK
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State | NY
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Zip | 10001-6405
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Country | US
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Telephone | 646-201-9457
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Fax |
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Provider Business Mailing Address
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Address Line | 280 PARK AVE S 18C
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City | NEW YORK
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State | NY
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Zip | 10010-6121
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Country | US
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Telephone | 516-782-8804
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Fax |
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Authorized Official
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Title or Position | OWNER/SPEECH-LANGUAGE PATHOLOGIST
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Name | AMY KELLER
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Credential | M.S. CCC-SLP
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Telephone | 646-201-9457
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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 | 017380-1
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License Number State | NY
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