Provider Demographics
NPI:1841472990
Name:CAPITOL AREA SPEECH AND LANGUAGE SERVICES, LLC
Entity type:Organization
Organization Name:CAPITOL AREA SPEECH AND LANGUAGE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:TRACHELL
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:MED, L-SLP
Authorized Official - Phone:225-202-1800
Mailing Address - Street 1:9518 GREENCHASE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-8809
Mailing Address - Country:US
Mailing Address - Phone:225-202-1800
Mailing Address - Fax:
Practice Address - Street 1:9518 GREENCHASE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-8809
Practice Address - Country:US
Practice Address - Phone:225-202-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4592252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency