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Organization

BRIDGING THE GAP SPEECH SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHANEL FAGAN (DIRECTOR)
(732) 948-6015
Entity
Organization

Contact information

Practice address
70 SUMMER ST, EDISON, NJ 08820-2436
(732) 948-6015
Mailing address
70 SUMMER ST, EDISON, NJ 08820-2436
(732) 948-6015

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00610100
NJ

Other

Enumeration date
03/07/2010
Last updated
03/07/2010
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