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General NPI Number Information
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NPI Number | 1619472917
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Entity Type | Organization
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Legal Business Name | KIDSPEAK SPEECH THERAPY, LLC
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Dates
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Enumeration Date | 03/28/2018
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Last Update Date | 03/28/2018
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Provider Practice Location Address
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Address Line | 217 MAIN ST
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City | NORTH READING
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State | MA
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Zip | 01864-3104
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Country | US
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Telephone | 781-276-4241
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Fax |
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Provider Business Mailing Address
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Address Line | 30 OXBOW CIR
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City | NORTH ANDOVER
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State | MA
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Zip | 01845-6360
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Country | US
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Telephone | 914-843-6414
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Fax |
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Authorized Official
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Title or Position | OWNER/SPEECH-LANGUAGE PATHOLOGIST
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Name | ALISON CHAMALLAS
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Credential | MS, CCC-SLP
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Telephone | 914-843-6414
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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 | 7345
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License Number State | MA
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