Provider Demographics
NPI:1023720281
Name:SPEECH SUCCESS
Entity type:Organization
Organization Name:SPEECH SUCCESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF SPEECH-LANGUAGE PATHOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:AHRENS
Authorized Official - Suffix:
Authorized Official - Credentials:SLPD
Authorized Official - Phone:201-247-2696
Mailing Address - Street 1:885 ORADELL AVE
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1924
Mailing Address - Country:US
Mailing Address - Phone:201-247-2696
Mailing Address - Fax:
Practice Address - Street 1:12 LINCOLN BLVD STE 103
Practice Address - Street 2:
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1173
Practice Address - Country:US
Practice Address - Phone:201-247-2696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty