Provider Demographics
NPI:1851135339
Name:ST THERAPY SERVICES LLC
Entity type:Organization
Organization Name:ST THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEAD SLP
Authorized Official - Prefix:
Authorized Official - First Name:SERENE
Authorized Official - Middle Name:G
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:954-701-3562
Mailing Address - Street 1:10641 NW 20TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-2307
Mailing Address - Country:US
Mailing Address - Phone:954-701-3562
Mailing Address - Fax:
Practice Address - Street 1:10000 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6135
Practice Address - Country:US
Practice Address - Phone:954-701-3562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty