Provider Demographics
NPI:1174877732
Name:CHARIS SPEECH THERAPY
Entity type:Organization
Organization Name:CHARIS SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTORA
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DE LOS ANGELES
Authorized Official - Last Name:ANDINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-220-5423
Mailing Address - Street 1:BH4 CALLE LA NINA
Mailing Address - Street 2:URBANIZACION BAIROA
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-1471
Mailing Address - Country:US
Mailing Address - Phone:178-722-0542
Mailing Address - Fax:
Practice Address - Street 1:16 CALLE AMATISTA
Practice Address - Street 2:URBANIZACION VILLA BLANCA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-1904
Practice Address - Country:US
Practice Address - Phone:787-220-5423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1099174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty