MEDICARE: THE LANGUAGE GARDEN, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1518115229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE LANGUAGE GARDEN, LLC

Provider Business Mailing Address
First Line	:	1404 HEATHER RIDGE RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-1579
Country	:	US
Telephone Number	:	702-325-4495
Fax Number	:

Provider Business Practice Location Address
First Line	:	1404 HEATHER RIDGE RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-1579
Country	:	US
Telephone Number	:	702-325-4495
Fax Number	:

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST
Name	:	MARLAINA HARRIS
Credential	:	MS,CCC-SLP
Telephone Number	:	702-325-4495

Provider Enumeration Date	:	09/05/2008
Last Update Date	:	09/05/2008

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Directions to “THE LANGUAGE GARDEN, LLC ” Practice Location

Language	Start Address	Practice Location

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