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General NPI Number Information
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NPI Number | 1255197075
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Entity Type | Organization
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Legal Business Name | SPEAK YOUR PATH SPEECH-LANGUAGE PATHOLOGY PLLC
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 135 MADISON ST
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City | FRANKLIN SQUARE
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State | NY
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Zip | 11010-2426
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Country | US
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Telephone | 516-506-9937
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Fax |
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Provider Business Mailing Address
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Address Line | 135 MADISON ST
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City | FRANKLIN SQUARE
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State | NY
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Zip | 11010-2426
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Country | US
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Telephone | 516-506-9937
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Fax |
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST
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Name | CRISINA ELIZABETH LISTER
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Credential | MS CCC-SLP
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Telephone | 516-506-9937
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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 |
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License Number State |
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