Provider Demographics
NPI:1750681706
Name:SPEECH AND LANGUAGE CONNECTIONS, LLC
Entity Type:Organization
Organization Name:SPEECH AND LANGUAGE CONNECTIONS, LLC
Other - Org Name:SPEECH AND LANGUAGE CONNECTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:LEEANN
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:KYRIAKIDES
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:763-315-6616
Mailing Address - Street 1:7231 - FORESTVIEW LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369
Mailing Address - Country:US
Mailing Address - Phone:763-315-6616
Mailing Address - Fax:763-315-8894
Practice Address - Street 1:7231 - FORESTVIEW LN N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369
Practice Address - Country:US
Practice Address - Phone:763-315-6616
Practice Address - Fax:763-315-8894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7514235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty