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Organization
SUPERCALIFRAGILISTIC SPEECH LANGUAGE THERAPY INC.
Active
Organization
SUPERCALIFRAGILISTIC SPEECH LANGUAGE THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIANA O'NEILL MS CCC-SLP (CEO/FOUNDER)
(203) 500-0969
Entity
Organization
Contact information
Practice address
1204 MAIN ST # 218, BRANFORD, CT 06405-3787
(203) 208-8377
Mailing address
1204 MAIN ST STE 218, BRANFORD, CT 06405-3787
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4809
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13500248
CAQH
—
Enumeration date
05/18/2017
Last updated
06/16/2018
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