Provider Demographics
NPI:1730677972
Name:LANGUAGE AND LITERACY SOLUTIONS, LLC
Entity Type:Organization
Organization Name:LANGUAGE AND LITERACY SOLUTIONS, LLC
Other - Org Name:LANGUAGE AND LITERACY SOLUTIONS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:CCC/SLP
Authorized Official - Phone:618-559-7105
Mailing Address - Street 1:3578 S ILLINOIS AVE
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62903-8364
Mailing Address - Country:US
Mailing Address - Phone:618-559-7105
Mailing Address - Fax:
Practice Address - Street 1:3578 S ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62903-8364
Practice Address - Country:US
Practice Address - Phone:618-559-7105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANGUAGE AND LITERACY SOLUTIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL140006150235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty