Provider Demographics
NPI:1437938446
Name:THE WOVEN VILLAGE, LLC
Entity Type:Organization
Organization Name:THE WOVEN VILLAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:JANG
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP, CLC
Authorized Official - Phone:334-246-1692
Mailing Address - Street 1:2807 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36804-7827
Mailing Address - Country:US
Mailing Address - Phone:334-246-1692
Mailing Address - Fax:334-746-7680
Practice Address - Street 1:2807 JACKSON ST
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36804-7827
Practice Address - Country:US
Practice Address - Phone:334-246-1692
Practice Address - Fax:334-746-7680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech