Provider Demographics
NPI:1407552177
Name:RESTORATIVE LANGUAGE THERAPY SERVICES
Entity Type:Organization
Organization Name:RESTORATIVE LANGUAGE THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KREIDER
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:912-248-2734
Mailing Address - Street 1:300 BRIDGEWATER LN
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:GA
Mailing Address - Zip Code:31305-3179
Mailing Address - Country:US
Mailing Address - Phone:912-248-2734
Mailing Address - Fax:
Practice Address - Street 1:300 BRIDGEWATER LN
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:GA
Practice Address - Zip Code:31305-3179
Practice Address - Country:US
Practice Address - Phone:912-248-2734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health