Healthcare Provider Details

I. General information

NPI: 1902307903
Provider Name (Legal Business Name): HARPER LANGUAGE & LEARNING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2018
Last Update Date: 09/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 WOLF CIR STE B
LAKE CHARLES LA
70605-2348
US

IV. Provider business mailing address

810 E KADE LN
LAKE CHARLES LA
70605-7197
US

V. Phone/Fax

Practice location:
  • Phone: 317-331-6574
  • Fax:
Mailing address:
  • Phone: 317-331-6574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberL-188
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number6270
License Number StateLA

VIII. Authorized Official

Name: SHANNON HARPER
Title or Position: OWNER
Credential: CCC-SLP , BCBA
Phone: 317-331-6574