MEDICARE: SUNSHINE SPEECH THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1164105714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE SPEECH THERAPY LLC

Provider Business Mailing Address
First Line	:	35 ALMY AVE
Second Line	:
City	:	WARREN
State	:	RI
Zip	:	02885-3701
Country	:	US
Telephone Number	:	401-595-2150
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 MAPLE AVE STE L06-C
Second Line	:
City	:	BARRINGTON
State	:	RI
Zip	:	02806-3432
Country	:	US
Telephone Number	:	401-595-2150
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGUAGE PATHOLOGIST
Name	:	KATHRYN DELGRECO
Credential	:	M.S. CCC-SLP
Telephone Number	:	401-595-2150

Provider Enumeration Date	:	08/10/2023
Last Update Date	:	08/10/2023

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Directions to “SUNSHINE SPEECH THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

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