1215314703 NPI number — SPEECH AND LANGUAGE CENTER PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215314703 NPI number — SPEECH AND LANGUAGE CENTER PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPEECH AND LANGUAGE CENTER PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215314703
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/04/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1591 PORT REPUBLIC RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKINGHAM
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22801-3517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-437-4226
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 SHENANDOAH AVENUE
Provider Second Line Business Practice Location Address:
SUITE 170
Provider Business Practice Location Address City Name:
ELKTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22827
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-437-4226
Provider Business Practice Location Address Fax Number:
540-437-4227
Provider Enumeration Date:
05/04/2015

Additional Information

Authorized Official

Authorized Official Last Name:
NALBERCZINSKI
Authorized Official First Name:
LORA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER, SPEECH PATHOLOGIST
Authorized Official Telephone Number:
540-578-0638

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  2202004333 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com