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General NPI Number Information
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NPI Number | 1922505437
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Entity Type | Organization
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Legal Business Name | SMALL TALK CHESCO, LLC
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Dates
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Enumeration Date | 04/11/2018
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 213 POTTSTOWN PIKE
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City | CHESTER SPRINGS
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State | PA
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Zip | 19425-9570
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Country | US
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Telephone | 267-265-1642
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Fax |
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Provider Business Mailing Address
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Address Line | 931 BRITTNEY TER
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-4423
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Country | US
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Telephone | 267-265-1642
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Fax |
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Authorized Official
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Title or Position | OWNER/SPEECH-LANGUAGE PATHOLOGIST
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Name | EMILY BETH CONSTANTINIDIS
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Credential | MS, CCC-SP
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Telephone | 267-265-1642
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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 | SL007808
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License Number State | PA
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