=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952733537
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NURTURE FEEDING AND COMMUNICATION SUPPORT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2013
-----------------------------------------------------
Last Update Date | 07/12/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 210 INDIANOLA RD
-----------------------------------------------------
City | CHESWICK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15024
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-708-2080
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 210 INDIANOLA RD
-----------------------------------------------------
City | CHESWICK
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15024-4012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-708-2080
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | CHERI RENEE GWIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 412-708-2080
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------