Provider Demographics
NPI:1609134774
Name:BAY AREA SPEECH LANGUAGE LEARNING ASSOCIATES
Entity Type:Organization
Organization Name:BAY AREA SPEECH LANGUAGE LEARNING ASSOCIATES
Other - Org Name:KRIST SAMARITAN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:BERG
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:281-488-7221
Mailing Address - Street 1:16703 BENTFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2233
Mailing Address - Country:US
Mailing Address - Phone:281-488-5754
Mailing Address - Fax:
Practice Address - Street 1:16703 BENTFIELD WAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2233
Practice Address - Country:US
Practice Address - Phone:281-488-5754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11235261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech