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General NPI Number Information
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NPI Number | 1396020780
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Entity Type | Organization
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Legal Business Name | BERKSHIRE SPEECH & LANGUAGE INSTITUTE
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 10/17/2011
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Provider Practice Location Address
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Address Line | 2325 HANCOCK RD
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City | WILLIAMSTOWN
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State | MA
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Zip | 01267-9727
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Country | US
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Telephone | 413-458-5824
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Fax |
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Provider Business Mailing Address
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Address Line | 2325 HANCOCK ROAD
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City | WILLIAMSTOWN
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State | MA
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Zip | 01267-9727
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Country | US
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Telephone | 413-458-5824
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | DR. STEPHEN L WHITE
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Credential | PH.D.
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Telephone | 413-458-5824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 846
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 7484
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License Number State | MA
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