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General NPI Number Information
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NPI Number | 1558180075
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Entity Type | Organization
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Legal Business Name | EXPRESS IT SPEECH-LANGUAGE PATHOLOGISTS
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 218 COMMONS WAY BLDG B
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City | TOMS RIVER
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State | NJ
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Zip | 08755-6427
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Country | US
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Telephone | 732-829-3047
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Fax | 732-608-9858
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Provider Business Mailing Address
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Address Line | 218 COMMONS WAY BLDG B
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City | TOMS RIVER
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State | NJ
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Zip | 08755-6427
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Country | US
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Telephone | 732-829-3047
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. JENNIFER D CLARKE
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Credential | PH.D.
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Telephone | 732-288-6825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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