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General NPI Number Information
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NPI Number | 1407991235
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Entity Type | Organization
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Legal Business Name | SPEECH AND LEARN SLP, PLLC
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1 EXECUTIVE BLVD 4TH FLOOR
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City | YONKERS
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State | NY
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Zip | 10701-6822
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Country | US
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Telephone | 914-457-9095
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Fax | 914-457-9332
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Provider Business Mailing Address
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Address Line | 1 EXECUTIVE BLVD 4TH FLOOR
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City | YONKERS
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State | NY
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Zip | 10701-6822
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Country | US
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Telephone | 914-457-9095
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Fax | 914-457-9332
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MRS. LAKISHA MEDINA
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Credential | CCC-SLP
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Telephone | 914-457-9095
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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 | 014400-1
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License Number State | NY
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