Healthcare Provider Details
I. General information
NPI: 1093846008
Provider Name (Legal Business Name): THERAPY AND LEARNING SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/08/2007
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
32772 DEER WATCH CT
NEW CARLISLE IN
46552-9690
US
IV. Provider business mailing address
32772 DEER WATCH CT
NEW CARLISLE IN
46552-9690
US
V. Phone/Fax
- Phone: 574-654-8540
- Fax: 574-654-9183
- Phone: 574-654-8540
- Fax: 574-654-9183
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 22003342A |
| License Number State | IN |
VIII. Authorized Official
Name: MRS.
JENNIFER
MARIE
HATFIELD
Title or Position: OWNERDIRECTOR
Credential: SLP
Phone: 574-654-8540