Provider Demographics
NPI:1538784756
Name:SPEECH LANGUAGE INSTITUTE
Entity type:Organization
Organization Name:SPEECH LANGUAGE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIVANI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAINA
Authorized Official - Suffix:
Authorized Official - Credentials:SLPD
Authorized Official - Phone:973-449-6277
Mailing Address - Street 1:38 WILLOW WAY
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-1855
Mailing Address - Country:US
Mailing Address - Phone:973-449-6277
Mailing Address - Fax:
Practice Address - Street 1:38 WILLOW WAY
Practice Address - Street 2:
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-1855
Practice Address - Country:US
Practice Address - Phone:973-449-6277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty