Provider Demographics
NPI:1356844021
Name:TO ADVANCE LANGUGE FOR KIDS
Entity Type:Organization
Organization Name:TO ADVANCE LANGUGE FOR KIDS
Other - Org Name:TALK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER/SLP
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:SHOCKEY
Authorized Official - Last Name:MORRILL
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:225-773-9791
Mailing Address - Street 1:15345 RANDI CT
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-4363
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15345 RANDI CT
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-4363
Practice Address - Country:US
Practice Address - Phone:225-773-9791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6435235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty