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General NPI Number Information
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NPI Number | 1639545387
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Entity Type | Organization
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Legal Business Name | PEARL BRAUN SPEECH AND LANGUAGE SERVICES LLC
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Dates
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Enumeration Date | 08/17/2015
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Last Update Date | 08/17/2015
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Provider Practice Location Address
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Address Line | 57 CARASALJO DR
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City | LAKEWOOD
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State | NJ
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Zip | 08701-2309
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Country | US
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Telephone | 917-797-9939
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Fax | 732-367-4858
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Provider Business Mailing Address
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Address Line | 57 CARASALJO DR
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City | LAKEWOOD
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State | NJ
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Zip | 08701-2309
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Country | US
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Telephone | 917-797-9939
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Fax | 732-367-4858
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Authorized Official
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Title or Position | OWNER
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Name | PEAL BRAUN
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Credential | SLP
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Telephone | 917-797-9939
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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 |
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License Number State |
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