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General NPI Number Information
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NPI Number | 1073724852
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Entity Type | Organization
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Legal Business Name | NORTHWEST SPEECH AND LANGUAGE CENTER
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2851 N TENAYA WAY STE 201
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City | LAS VEGAS
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State | NV
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Zip | 89128-0453
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Country | US
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Telephone | 702-449-5105
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Fax | 702-430-9826
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Provider Business Mailing Address
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Address Line | 9538 MILKWEED CANYON AVE
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City | LAS VEGAS
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State | NV
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Zip | 89166-3759
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Country | US
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Telephone | 702-449-5105
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Fax | 702-430-9826
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. ALICE B FERLAND
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Credential | MCD CCC-SLP
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Telephone | 702-449-5105
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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 | 728581
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License Number State | NV
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