MID-ISLAND SPEECH LANGUAGE PATHOLOGY PLLC NPI 1780191288

NPI Information

  • NPI: 1780191288
  • Provider Name: MID-ISLAND SPEECH LANGUAGE PATHOLOGY, PLLC
  • Classification: Speech-Language Pathologist - 235Z00000X
  • Entity Type: Organization
  • Address: 24 DONALD STREET
    HOLBROOK, NY
    ZIP 11741
  • Phone: (631) 387-1926

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NPI Details

MID-ISLAND SPEECH LANGUAGE PATHOLOGY, PLLC is a speech language pathologist in Holbrook, NY. 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. MID-ISLAND SPEECH LANGUAGE PATHOLOGY, PLLC NPI is 1780191288. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

24 DONALD STREET
HOLBROOK, NY
ZIP 11741
Phone: (631) 387-1926

The provider's authorized official is Jaclyn Havlicek .
The authorized official title is Speech Pathologist, Owner and has the following contact phone number (631) 387-1926.

The enumeration date for this NPI number is 1/5/2018 and was last updated on 1/5/2018.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1235Z00000XSpeech-Language Pathologist108418NEW YORKYes

What is NPI?

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This page was last updated on: 3/30/2025

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