Organization Name: | INTEGRATED CHILDREN'S THERAPIES |
NPI Number: | 1245472554 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LISA VAN GORDER (OWNER) |
Mailing Address: | 72 Jefferson Street Marlborough |
State: | MA US |
Postal Code: | 01752 |
Phone Number: | 5084855650 |
Fax Number: | 5084855423 |
NPI Enumeration Date: | 04/01/2009 |
NPI Last Update Date: | 04/01/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 6596 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
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 |