Provider Demographics
NPI:1649448028
Name:THE THERAPY AND LEARNING CENTER INC
Entity type:Organization
Organization Name:THE THERAPY AND LEARNING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BODINE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC, SLP
Authorized Official - Phone:863-644-6200
Mailing Address - Street 1:5705 S FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2566
Mailing Address - Country:US
Mailing Address - Phone:863-644-6200
Mailing Address - Fax:863-647-5465
Practice Address - Street 1:5705 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2566
Practice Address - Country:US
Practice Address - Phone:863-644-6200
Practice Address - Fax:863-647-5465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8267235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty