Provider Demographics
NPI:1346539277
Name:SPEECH LANGUAGE AND LEARNING FOR LIFE PC
Entity Type:Organization
Organization Name:SPEECH LANGUAGE AND LEARNING FOR LIFE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:972-951-7909
Mailing Address - Street 1:5929 ANDOVER DR APT 25
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-5248
Mailing Address - Country:US
Mailing Address - Phone:972-951-7909
Mailing Address - Fax:
Practice Address - Street 1:1125 LEGACY DR STE 210
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-1943
Practice Address - Country:US
Practice Address - Phone:972-951-7909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty