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General NPI Number Information
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NPI Number | 1295504777
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Entity Type | Organization
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Legal Business Name | CONNECTED THERAPY LLC
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Dates
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Enumeration Date | 12/26/2023
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Last Update Date | 12/26/2023
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Provider Practice Location Address
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Address Line | 11442 GARDEN CRESS TRL
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-4226
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Country | US
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Telephone | 954-288-8914
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N STE 18101
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4305
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Country | US
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Telephone | 954-288-8914
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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 | JESSIE GINSBURG BARAK
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Credential | MS CCC-SLP
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Telephone | 954-288-8914
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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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