Provider Demographics
NPI:1730623877
Name:ALLIANCE SPEECH & LANGUAGE CENTER, LLC
Entity type:Organization
Organization Name:ALLIANCE SPEECH & LANGUAGE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRSH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:732-942-7220
Mailing Address - Street 1:4691 HWY 9
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3384
Mailing Address - Country:US
Mailing Address - Phone:732-942-7220
Mailing Address - Fax:732-942-7225
Practice Address - Street 1:4691 HWY 9
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3384
Practice Address - Country:US
Practice Address - Phone:732-942-7220
Practice Address - Fax:732-942-7225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00198700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1366435489OtherNPI INIVIDUAL