MEDICARE: EXPAND ABILITIES

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	:	1386455814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXPAND ABILITIES

Provider Business Mailing Address
First Line	:	40 WILSON RD
Second Line	:
City	:	LITCHFIELD
State	:	CT
Zip	:	06759-2621
Country	:	US
Telephone Number	:	860-483-8311
Fax Number	:

Provider Business Practice Location Address
First Line	:	457 BANTAM RD
Second Line	:
City	:	LITCHFIELD
State	:	CT
Zip	:	06759-3225
Country	:	US
Telephone Number	:	860-483-8311
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LAUREN MARIETTI
Credential	:	CCC-SLP
Telephone Number	:	860-483-8311

Provider Enumeration Date	:	01/15/2025
Last Update Date	:	01/15/2025

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Directions to “EXPAND ABILITIES ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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