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General NPI Number Information
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NPI Number | 1225431836
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Entity Type | Organization
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Legal Business Name | EXPRESS COMMUNICATION THERAPY/COMUNICATE CONMIGO THERAPY, PLLC
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Dates
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Enumeration Date | 09/28/2014
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Last Update Date | 09/28/2014
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Provider Practice Location Address
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Address Line | 226 JULIAN POND LN
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City | KERNERSVILLE
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State | NC
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Zip | 27284-2461
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Country | US
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Telephone | 201-921-1956
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Fax |
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Provider Business Mailing Address
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Address Line | 226 JULIAN POND LN
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City | KERNERSVILLE
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State | NC
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Zip | 27284-2461
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SPEECH AND LANGUAGE PATHOLOGIST
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Name | MRS. ANA MARIA MARIA RENDON
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Credential | M.S
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Telephone | 201-921-1956
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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 | 9370
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License Number State | NC
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