1902161409 NPI number — LEARNING AND THERAPY CORNER

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 1902161409 NPI number — LEARNING AND THERAPY CORNER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LEARNING AND THERAPY CORNER
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:
1902161409
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/11/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1818 POT SPRING RD
Provider Second Line Business Mailing Address:
SUITE 30
Provider Business Mailing Address City Name:
LUTHERVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21093-4445
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-583-5765
Provider Business Mailing Address Fax Number:
410-560-0007

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1818 POT SPRING RD
Provider Second Line Business Practice Location Address:
SUITE 30
Provider Business Practice Location Address City Name:
LUTHERVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21093-4445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-583-5765
Provider Business Practice Location Address Fax Number:
410-560-0007
Provider Enumeration Date:
07/10/2012

Additional Information

Authorized Official

Authorized Official Last Name:
LEKAS
Authorized Official First Name:
MEGAN
Authorized Official Middle Name:
Authorized Official Title or Position:
SPEECH-LANGUAGE PATHOLOGIST
Authorized Official Telephone Number:
410-583-5765

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  06961 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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