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General NPI Number Information
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NPI Number | 1710366034
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Entity Type | Organization
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Legal Business Name | CHILDREN'S SPEECH AND HEARING SPECIALISTS, LLC
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Dates
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Enumeration Date | 05/19/2015
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Last Update Date | 05/19/2015
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Provider Practice Location Address
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Address Line | 128 WHEELER RD
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City | BURLINGTON
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State | MA
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Zip | 01803-5197
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Country | US
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Telephone | 781-365-0316
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Fax |
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Provider Business Mailing Address
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Address Line | 128 WHEELER RD
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City | BURLINGTON
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State | MA
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Zip | 01803-5197
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIELLE JARJURA
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Credential | M.S., CCC-SLP
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Telephone | 781-365-0316
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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 | 9154
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License Number State | MA
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