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Organization

VINE SPEECH PATHOLOGY, CORP.

Active
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Organization

VINE SPEECH PATHOLOGY, CORP.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAROLINE DUARTE (SPEECH LANGUAGE PATHOLOGIST/CEO)
(570) 620-4346
Entity
Organization

Contact information

Practice address
246 STADDEN RD STE 103, TANNERSVILLE, PA 18372-7944
(570) 620-4346
(570) 620-4342
Mailing address
134 BEEHLER RD, STROUDSBURG, PA 18360-7663
(347) 310-5985
(570) 620-4342

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1035895390002
PA
Enumeration date
03/13/2019
Last updated
03/13/2019
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