Provider Demographics
NPI:1508267154
Name:HOWARD UNIVERSITY
Entity Type:Organization
Organization Name:HOWARD UNIVERSITY
Other - Org Name:SPEECH LANGUAGE AND AUDIOLOGY CTR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOC. VP ADMIN AND OPERATIONS MS
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:MSHA
Authorized Official - Phone:202-806-6970
Mailing Address - Street 1:2024 GEORGIA AVE NW
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3027
Mailing Address - Country:US
Mailing Address - Phone:202-865-4132
Mailing Address - Fax:
Practice Address - Street 1:525 BRYANT ST NW
Practice Address - Street 2:ROOM 139Y
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20059-1005
Practice Address - Country:US
Practice Address - Phone:202-806-6991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG01113Medicare PIN