| Organization Name: | SPEECH ACADEMY LLC |
| NPI Number: | 1588965834 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BETH ANN SHANKS (SPEECH LANGUAGE PATHOLOGIST/OWNER) |
| Mailing Address: | 231 Crosswicks Rd Suite 4 Bordentown |
| State: | NJ US |
| Postal Code: | 085052602 |
| Phone Number: | 6093724613 |
| Fax Number: | 6093724618 |
| NPI Enumeration Date: | 11/03/2010 |
| NPI Last Update Date: | 11/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 41YS00015200 |
| 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 |