=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306774369
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABC DEES SPEECH INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/11/2026
-----------------------------------------------------
Last Update Date | 05/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 305 WEYMOUTH ST
-----------------------------------------------------
City | DIX HILLS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11746-7038
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-987-9239
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 305 WEYMOUTH ST
-----------------------------------------------------
City | DIX HILLS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11746-7038
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-987-9239
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | MRS. DEIDRE HOPE KOTSIOPOULOS
-----------------------------------------------------
Credential | MA CCC-SLP
-----------------------------------------------------
Telephone | 631-987-9239
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------