Organization Name: | BRIAN'S T.E.A.M. LLC |
NPI Number: | 1033522669 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KERRY CRON (OWNER/SPEECH LANGUAGE PATHOLOGIST) |
Mailing Address: | 22 Riverview Dr C/o Brian's T.e.a.m. Wayne |
State: | NJ US |
Postal Code: | 074703115 |
Phone Number: | 9736280400 |
Fax Number: | 9736271724 |
NPI Enumeration Date: | 06/11/2014 |
NPI Last Update Date: | 06/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 41YS00470500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |