=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336018142
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TINY HUMANS COLLECTIVE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/30/2025
-----------------------------------------------------
Last Update Date | 10/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2981 MORELAND AVE
-----------------------------------------------------
City | OCEANSIDE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11572-4734
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-445-6177
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2981 MORELAND AVE
-----------------------------------------------------
City | OCEANSIDE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11572-4734
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-445-6177
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH-LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | JULIA COHEN
-----------------------------------------------------
Credential | MS CCC-SLP TSSLD
-----------------------------------------------------
Telephone | 516-445-6177
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------