Organization
INTEGRATED SPEECH PATHOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA SPILLMAN KENNEDY M.S. (SPEECH-LANGUAGE PATHOLOGIST)
(866) 539-6685
Entity
Organization
Contact information
Practice address
786 MOUNTAIN BLVD STE 203B, WATCHUNG, NJ 07069-6268
(866) 539-6685
Mailing address
26 SNEIDER RD, WARREN, NJ 07059-7042
(908) 256-3575
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YSO O1580
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01062059
ASHA
—
01
—
YSO O1580
NJ STATE LICENSE NUMBER
NJ
Enumeration date
05/05/2016
Last updated
05/05/2016
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