Provider Demographics
NPI:1578028221
Name:FREEDOM TORCH CONSULTING, INC.
Entity type:Organization
Organization Name:FREEDOM TORCH CONSULTING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THERESE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGSTED
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SP
Authorized Official - Phone:516-225-4156
Mailing Address - Street 1:439 E RIVER DR
Mailing Address - Street 2:
Mailing Address - City:LAKE LUZERNE
Mailing Address - State:NY
Mailing Address - Zip Code:12846-1912
Mailing Address - Country:US
Mailing Address - Phone:516-225-4156
Mailing Address - Fax:
Practice Address - Street 1:439 E RIVER DR
Practice Address - Street 2:
Practice Address - City:LAKE LUZERNE
Practice Address - State:NY
Practice Address - Zip Code:12846-1912
Practice Address - Country:US
Practice Address - Phone:516-225-4156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty