Organization
PEDIA-REHAB, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE URSULA SIMON MS CCC-SLP (OWNER OF CORPORATION SPEECH-LANGUAG)
(973) 827-6039
Entity
Organization
Contact information
Practice address
30 BEAVER RUN RD, HAMBURG, NJ 07419
(973) 827-6039
Mailing address
30 BEAVER RUN RD, HAMBURG, NJ 07419
(973) 827-6039
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00255000
NJ
235Z00000X
Speech-Language Pathologist
4978
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0093003GA
—
GA
Enumeration date
12/05/2006
Last updated
07/21/2022
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