Vine Speech Pathology, Corp.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

VINE SPEECH PATHOLOGY, CORP.

Practice address

246 Stadden Rd Ste 103
Tannersville, PA 18372-7944

Phone

(570) 620-4346

Fax

(570) 620-4342

NPI assigned

Mar 13, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Caroline Duarte

Title

Speech Language Pathologist/Ceo

Phone

(570) 620-4346

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552435200000",
    "number": "1366901985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 BEEHLER RD",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183607663",
            "telephone_number": "347-310-5985",
            "fax_number": "570-620-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 STADDEN RD STE 103",
            "city": "TANNERSVILLE",
            "state": "PA",
            "postal_code": "183727944",
            "telephone_number": "570-620-4346",
            "fax_number": "570-620-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINE SPEECH PATHOLOGY, CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A",
        "authorized_official_last_name": "DUARTE",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST/CEO",
        "authorized_official_telephone_number": "570-620-4346"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035895390002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Tannersville, PA
• Providers in Tannersville, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.