Provider Demographics
NPI:1285927913
Name:GROWING WORDS, SPEECH AND LANGUAGE THERAPY, PLLC
Entity type:Organization
Organization Name:GROWING WORDS, SPEECH AND LANGUAGE THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KETURAH
Authorized Official - Middle Name:K
Authorized Official - Last Name:PERKINS-TREMBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:518-677-5651
Mailing Address - Street 1:33 GILBERT ST
Mailing Address - Street 2:SUITE E,
Mailing Address - City:CAMBRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:12816-2643
Mailing Address - Country:US
Mailing Address - Phone:518-796-8001
Mailing Address - Fax:518-677-5651
Practice Address - Street 1:33 GILBERT ST
Practice Address - Street 2:SUITE E,
Practice Address - City:CAMBRIDGE
Practice Address - State:NY
Practice Address - Zip Code:12816-2643
Practice Address - Country:US
Practice Address - Phone:518-796-8001
Practice Address - Fax:518-677-5651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014635261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1366731564OtherNPI