Provider Demographics
NPI:1386896967
Name:SKYLANDS SPEECH AND LANGUAGE THERAPY LLC
Entity type:Organization
Organization Name:SKYLANDS SPEECH AND LANGUAGE THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:F
Authorized Official - Last Name:CASSERLY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:973-948-5701
Mailing Address - Street 1:318 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-6859
Mailing Address - Country:US
Mailing Address - Phone:973-948-5701
Mailing Address - Fax:
Practice Address - Street 1:318 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-6859
Practice Address - Country:US
Practice Address - Phone:973-948-5701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00138400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty