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PORTLAND PEDIATRIC SPEECH THERAPY NPI 1164966529


NPI Information

NPI: 1164966529
Provider Name: PORTLAND PEDIATRIC SPEECH THERAPY
Classification: Speech-Language Pathologist - 235Z00000X
Entity Type: Organization

CLIA Number: 20D2156912

Address:
341 HIGHLAND AVE # 1
SOUTH PORTLAND, ME
ZIP 04106
Phone: (301) 802-8342
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PORTLAND PEDIATRIC SPEECH THERAPY is a speech language pathologist in South Portland, ME. The provider is the speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. PORTLAND PEDIATRIC SPEECH THERAPY NPI is 1164966529. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

341 HIGHLAND AVE # 1
SOUTH PORTLAND, ME
ZIP 04106-510
Phone: (301) 802-8342

The provider's authorized official is Susan Bahadori .
The authorized official title is Speech-language Pathologist and has the following contact phone number (301) 802-8342.

The CLIA number assigned to this NPI record is 20D2156912 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/5/2016 and was last updated on 12/5/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1235Z00000XSpeech-Language PathologistSP2317MAINEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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