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General NPI Number Information
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NPI Number | 1639601750
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Entity Type | Organization
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Legal Business Name | SPEECH AND HEARING SERVICES
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | 17 BROOKS AVE UNIT1
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City | HUNTINGTON
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State | NY
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Zip | 11743
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Country | US
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Telephone | 347-866-5237
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Fax |
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Provider Business Mailing Address
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Address Line | 17 BROOKS AVE UNIT 1
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City | HUNTINGTON
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State | NY
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Zip | 11743-6202
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Country | US
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Telephone | 347-866-5237
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/SPEECH PATHOLOGIST
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Name | DR. KANDICE BAKER
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Credential |
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Telephone | 347-866-5237
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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 | 017708
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License Number State | NY
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