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General NPI Number Information
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NPI Number | 1295980761
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Entity Type | Organization
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Legal Business Name | CREATIVE COMMUNICATIONS SPEECH-LANGUAGE PATHOLOGY
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Dates
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Enumeration Date | 11/24/2008
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Last Update Date | 11/24/2008
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Provider Practice Location Address
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Address Line | 398 COUNTY ROUTE 54
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City | SCHAGHTICOKE
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State | NY
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Zip | 12154-2014
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Country | US
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Telephone | 518-669-5538
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Fax |
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Provider Business Mailing Address
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Address Line | 398 COUNTY ROUTE 54
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City | SCHAGHTICOKE
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State | NY
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Zip | 12154-2014
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Country | US
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Telephone | 518-669-5538
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. BARBARA JEAN MOLISKY
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Credential | MS, CCC-SLP
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Telephone | 15186695538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 012682
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License Number State | NY
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