Request an Appointment

Providers: Register Here

To register with Open Lines Speech and Communication PLLC for NYCDOE opportunities 2012-2015, complete the information below.

Registering with Open Lines will not exclude you from working with other agencies or from accepting cases independently.

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* Required information.
Provider Registration *
Yes, I would like to be listed as a provider for Open Lines.
No, I am not interested in being listed as a provider for Open Lines.
Name: *
Discipline: *
Address:
Primary Phone: *
Secondary Phone:
Email: *
Degree: *
Degree Grantor Name (University): *
Graduation Date (month / day / year): *
SLP License Number: *
SLP License Issue Date: *
SLP Registration Expiration Date: *
TSHH or TSSLD? *
NPI: