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NPI 1053844720

NPI 1053844720 : SPEECH-LANGUAGE CONNECTIONS THERAPY : LITTLE ROCK, AR

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General NPI Number Information
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    NPI Number           |    1053844720
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    Entity Type          |    Organization 
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    Legal Business Name  |    SPEECH-LANGUAGE CONNECTIONS THERAPY 
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Dates
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    Enumeration Date     |    04/09/2017
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    Last Update Date     |    04/09/2017
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Provider Practice Location Address
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    Address Line         |    9321 LABETTE DR 
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    City                 |    LITTLE ROCK
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    State                |    AR
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    Zip                  |    72205-6812
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    Country              |    US
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    Telephone            |    501-803-6960
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9321 LABETTE DR 
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    City                 |    LITTLE ROCK
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    State                |    AR
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    Zip                  |    72205-6812
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    Country              |    US
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    Telephone            |    501-803-6960
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MS. DORECIE RENEE LENZIE 
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    Credential           |    M.S., CCC-SLP
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    Telephone            |    501-803-6960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    SP#3495
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    License Number State |    AR
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