Lakeside Therapy Group in Bridgeport - Speech-language Pathologist
Lakeside Therapy Group - NPI 1033312574
Lakeside Therapy Group is a Speech-language Pathologist in Bridgeport, . Lakeside Therapy Group practices all healthcare services and medical treatments related to Speech-language Pathologist. The NPI Number for Lakeside Therapy Group is 1033312574. The last update date is 2020-08-22.
Lakeside Therapy Group's current location address is 765 Brightridge Drive, Bridgeport, . You can contact this provider via phone number 3048440099 and fax number 3048480265. The mailing address for Lakeside Therapy Group is 765 Brightridge Drive, Bridgeport, . To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lakeside Therapy Group |
|---|---|
| Address | 765 Brightridge Drive, Bridgeport, |
| Phone Number | 3048440099 |
| Fax Number | 3048480265 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MEMBER SP |
|---|---|
| Authorized Official Name | Bastin Elizabeth Stacy |
| Credentials | MA CCC SLP |
| Telephone Number | 3048440099 |
NPI Number Detail
| NPI Number | 1033312574 |
|---|---|
| Provider Enumeration Date | 2007-06-11 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 765 Brightridge Drive |
|---|---|
| City | Bridgeport |
| State | (WV) |
| Post Code | 26330 |
| Phone Number | 3048440099 |
| Fax Number | 3048480265 |
Provider's Primary Taxonomy Detail
| Speciality | Speech-language Pathologist |
|---|---|
| Taxonomy | 235Z00000X |
| Licence No | SLP 0710 |
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Definition: The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Spe |
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What is the unique identifier code issued to Lakeside Therapy Group by the Centers for Medicare & Medicaid Services?
The Lakeside Therapy Group has been assigned the NPI (National Provider Identifier) 1033312574. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Lakeside Therapy Group is physically located?
The Lakeside Therapy Group is situated at the following address: 765 Brightridge Drive, Bridgeport, WV 26330.
What is the Lakeside Therapy Group's specialty and taxonomy code?
The Lakeside Therapy Group's specialty is Speech-language Pathologist, and the corresponding taxonomy code is 235Z00000X.
When did Lakeside Therapy Group receive its 1033312574 assignment?
The Lakeside Therapy Group was assigned its 1033312574 on 2007-06-11, which is the date when this unique identifier was issued to the organization.
As of what date were the details related to Lakeside Therapy Group most recently updated or revised?
The information pertaining to Lakeside Therapy Group, including its address, specialty, and other relevant details, was last updated or revised on 2020-08-22.
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