Organization
PHASE & STAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AVERY BEVILLE M.S., CCC-SLP (SLP/OWNER)
(361) 935-6990
Entity
Organization
Contact information
Practice address
33 LAUREL MOUNTAIN RD, WARREN, CT 06754-1723
(361) 935-6990
Mailing address
33 LAUREL MOUNTAIN RD, WARREN, CT 06754-1723
(361) 935-6990
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
05/10/2022
Last updated
05/10/2022
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