Provider Demographics
NPI:1215034426
Name:LANGUAGE & MOVEMENT
Entity Type:Organization
Organization Name:LANGUAGE & MOVEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:BA, SPEECH PATHOLOGY
Authorized Official - Phone:512-451-0961
Mailing Address - Street 1:PO BOX 15024
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78761-5024
Mailing Address - Country:US
Mailing Address - Phone:512-451-0961
Mailing Address - Fax:512-451-9745
Practice Address - Street 1:111 W ANDERSON LANE
Practice Address - Street 2:SUITE C-100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-1119
Practice Address - Country:US
Practice Address - Phone:512-451-0961
Practice Address - Fax:512-451-9745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QD1600X
TX0056CM261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0056CMOtherBCBS PROVIDER ID