Provider Demographics
NPI:1588383483
Name:ALL 4 THERAPY
Entity type:Organization
Organization Name:ALL 4 THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE-ANGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MALYAROVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:201-410-3979
Mailing Address - Street 1:200 WANAQUE AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-2130
Mailing Address - Country:US
Mailing Address - Phone:862-666-1692
Mailing Address - Fax:
Practice Address - Street 1:200 WANAQUE AVE STE 302
Practice Address - Street 2:
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442-2130
Practice Address - Country:US
Practice Address - Phone:862-666-1692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-24
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty