Healthcare Provider Details

I. General information

NPI: 1215314703
Provider Name (Legal Business Name): SPEECH AND LANGUAGE CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2015
Last Update Date: 05/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SHENANDOAH AVENUE SUITE 170
ELKTON VA
22827
US

IV. Provider business mailing address

1591 PORT REPUBLIC RD
ROCKINGHAM VA
22801-3517
US

V. Phone/Fax

Practice location:
  • Phone: 540-437-4226
  • Fax: 540-437-4227
Mailing address:
  • Phone: 540-437-4226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2202004333
License Number StateVA

VIII. Authorized Official

Name: LORA NALBERCZINSKI
Title or Position: OWNER, SPEECH PATHOLOGIST
Credential: MS, CCC-SLP
Phone: 540-578-0638