Provider Demographics
NPI:1447948120
Name:SPEAK YOUR LEGACY INC.
Entity type:Organization
Organization Name:SPEAK YOUR LEGACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:LUPO
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP, TSSLD, CDP
Authorized Official - Phone:631-624-6755
Mailing Address - Street 1:714 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-5521
Mailing Address - Country:US
Mailing Address - Phone:631-505-0576
Mailing Address - Fax:
Practice Address - Street 1:714 S 8TH ST
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-5521
Practice Address - Country:US
Practice Address - Phone:631-505-0576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management