Provider Demographics
NPI:1477034890
Name:CAPITAL SPEECH AND LANGUAGE THERAPY CENTER, LLC
Entity Type:Organization
Organization Name:CAPITAL SPEECH AND LANGUAGE THERAPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER-PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANERISH
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNE-REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:240-632-0325
Mailing Address - Street 1:17111 RUSSET DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3629
Mailing Address - Country:US
Mailing Address - Phone:240-632-0325
Mailing Address - Fax:301-464-5258
Practice Address - Street 1:17111 RUSSET DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3629
Practice Address - Country:US
Practice Address - Phone:240-632-0325
Practice Address - Fax:301-464-5258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech