Provider Demographics
NPI:1205485489
Name:SPEECH AND LANGUAGE FOR KIDS LLC
Entity type:Organization
Organization Name:SPEECH AND LANGUAGE FOR KIDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:METAXAS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:847-852-0928
Mailing Address - Street 1:3510 SILVERSIDE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4937
Mailing Address - Country:US
Mailing Address - Phone:302-415-3382
Mailing Address - Fax:302-351-8852
Practice Address - Street 1:3526 SILVERSIDE RD STE 37
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4901
Practice Address - Country:US
Practice Address - Phone:302-415-3382
Practice Address - Fax:302-351-8852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-10
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty