Provider Demographics
NPI:1982096806
Name:LISTEN2LEARN SPEECH THERAPY LLC
Entity Type:Organization
Organization Name:LISTEN2LEARN SPEECH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH PATHOLOGIST- AVT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRETA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLADOUHOS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP LSLS AVT
Authorized Official - Phone:907-868-2753
Mailing Address - Street 1:PO BOX 221795
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99522-1795
Mailing Address - Country:US
Mailing Address - Phone:907-868-2753
Mailing Address - Fax:907-868-1410
Practice Address - Street 1:4050 LAKE OTIS PKWY
Practice Address - Street 2:201
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5223
Practice Address - Country:US
Practice Address - Phone:907-868-2753
Practice Address - Fax:907-868-1410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK287235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty