Provider Demographics
NPI:1003068768
Name:MIRIAM LEARNING CENTER
Entity Type:Organization
Organization Name:MIRIAM LEARNING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:THORP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-962-6059
Mailing Address - Street 1:501 BACON AVE
Mailing Address - Street 2:
Mailing Address - City:WEBSTER GROVES
Mailing Address - State:MO
Mailing Address - Zip Code:63119-1512
Mailing Address - Country:US
Mailing Address - Phone:314-961-1500
Mailing Address - Fax:314-968-7338
Practice Address - Street 1:501 BACON AVE
Practice Address - Street 2:
Practice Address - City:WEBSTER GROVES
Practice Address - State:MO
Practice Address - Zip Code:63119-1512
Practice Address - Country:US
Practice Address - Phone:314-961-1500
Practice Address - Fax:314-968-7338
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIRIAM FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty