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General NPI Number Information
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NPI Number | 1811695653
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Entity Type | Organization
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Legal Business Name | KEYSTONE SPEECH THERAPY, LLC
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Dates
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Enumeration Date | 02/21/2023
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Last Update Date | 02/21/2023
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Provider Practice Location Address
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Address Line | 1529 GREEN ST APT B
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City | PHILADELPHIA
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State | PA
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Zip | 19130-4046
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Country | US
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Telephone | 267-301-3789
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Fax |
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Provider Business Mailing Address
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Address Line | 1735 MARKET ST STE A
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City | PHILADELPHIA
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State | PA
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Zip | 19103-7502
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Country | US
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Telephone | 267-301-3789
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CLINICAL DIRECTOR
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Name | MENG BROOKS-MCLENDON
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Credential | MS, CCC-SLP
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Telephone | 267-301-3789
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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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