Provider Demographics
NPI:1245468214
Name:THE SPEECH LANGUAGE LEARNING CENTER, INC.
Entity type:Organization
Organization Name:THE SPEECH LANGUAGE LEARNING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:V
Authorized Official - Last Name:LOCKE
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:810-733-3911
Mailing Address - Street 1:5065 MILLER RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-1037
Mailing Address - Country:US
Mailing Address - Phone:810-733-3911
Mailing Address - Fax:810-733-3912
Practice Address - Street 1:5065 MILLER RD
Practice Address - Street 2:SUITE 6
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1037
Practice Address - Country:US
Practice Address - Phone:810-733-3911
Practice Address - Fax:810-733-3912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty