| Organization Name: | SUGAR PLUM SPEECH |
| NPI Number: | 1871905059 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JESSICA LYN GIBBONS (OWNER, SPEECH-LANGUAGE PATHOLOGIST) |
| Mailing Address: | 2071 Route 209 Brodheadsville |
| State: | PA US |
| Postal Code: | 18322 |
| Phone Number: | 5702368380 |
| Fax Number: | 5703554097 |
| NPI Enumeration Date: | 05/22/2014 |
| NPI Last Update Date: | 09/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SL008632 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| 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 |