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General NPI Number Information
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NPI Number | 1336858505
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Entity Type | Organization
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Legal Business Name | LEARN. EAT. TALK. SMILE. SPEECH THERAPY
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Dates
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Enumeration Date | 11/16/2022
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 132 VANDERBILT BLVD
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City | OAKDALE
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State | NY
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Zip | 11769-2033
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Country | US
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Telephone | 631-790-5282
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Fax |
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Provider Business Mailing Address
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Address Line | 132 VANDERBILT BLVD
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City | OAKDALE
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State | NY
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Zip | 11769-2033
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Country | US
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Telephone | 631-790-5282
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGISTDIRECTOR
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Name | ANGELIQUE LICARI
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Credential | MS CCC-SLP
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Telephone | 631-790-5282
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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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