Provider Demographics
NPI:1760506430
Name:THE LANGUAGE LEARNING CENTER
Entity Type:Organization
Organization Name:THE LANGUAGE LEARNING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:GROSS
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:912-729-2294
Mailing Address - Street 1:69 LINDSEY LN STE A
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-1702
Mailing Address - Country:US
Mailing Address - Phone:912-729-2294
Mailing Address - Fax:912-673-9457
Practice Address - Street 1:69 LINDSEY LN STE A
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-1702
Practice Address - Country:US
Practice Address - Phone:912-729-2294
Practice Address - Fax:912-673-9457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA300034549AMedicaid