1326472440 NPI number — THERAPY FOR LANGUAGE AND COMMUNICATION, LLC

Table of content: DARBY BENSLEY MS, SLP (NPI 1225648462)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326472440 NPI number — THERAPY FOR LANGUAGE AND COMMUNICATION, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THERAPY FOR LANGUAGE AND COMMUNICATION, LLC
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:
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Provider Other Credential Text:
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NPI Number Information

NPI Number:
1326472440
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
60 CHURCH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WALLINGFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06492-2340
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
60 CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WALLINGFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06492-2340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-410-0974
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/26/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LAVALLEY
Authorized Official First Name:
LYNN
Authorized Official Middle Name:
Authorized Official Title or Position:
SPEECH-LANGUAGE PATHOLOGIST/OWNER
Authorized Official Telephone Number:
203-410-0974

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  3484 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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