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General NPI Number Information
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NPI Number | 1659624344
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Entity Type | Organization
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Legal Business Name | QUIET CORNER SPEECH & LANGUAGE LLC
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Dates
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Enumeration Date | 10/18/2012
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 1774B ROUTE 197
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City | WOODSTOCK
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State | CT
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Zip | 06281-1228
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Country | US
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Telephone | 860-821-0460
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Fax |
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Provider Business Mailing Address
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Address Line | 1774B ROUTE 197
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City | WOODSTOCK
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State | CT
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Zip | 06281-1228
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Country | US
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Telephone | 860-367-3371
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CHRISTINA COOK
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Credential |
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Telephone | 860-821-0460
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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 | 3858
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License Number State | CT
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