Provider Demographics
NPI:1972987196
Name:PUPPYLOVE SPEECH THERAPY LLC
Entity type:Organization
Organization Name:PUPPYLOVE SPEECH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAWADA
Authorized Official - Suffix:
Authorized Official - Credentials:MA/CCC SLP
Authorized Official - Phone:609-222-3957
Mailing Address - Street 1:17 STRATTON CT
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-3109
Mailing Address - Country:US
Mailing Address - Phone:609-222-3957
Mailing Address - Fax:609-301-7155
Practice Address - Street 1:17 STRATTON CT
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-3109
Practice Address - Country:US
Practice Address - Phone:609-222-3957
Practice Address - Fax:609-301-7155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00474300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty