=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447075023
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BE YOU SPEECH THERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/19/2024
-----------------------------------------------------
Last Update Date | 11/19/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 216 KICHLINE AVE
-----------------------------------------------------
City | HELLERTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18055-1026
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-273-2131
-----------------------------------------------------
Fax | 855-582-1230
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1515 BUSHKILL ST
-----------------------------------------------------
City | EASTON
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18042-3118
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-221-0255
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH THERAPIST
-----------------------------------------------------
Name | KRISTA NICOLETTA
-----------------------------------------------------
Credential | MS
-----------------------------------------------------
Telephone | 484-221-0255
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------