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General NPI Number Information
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NPI Number | 1215925896
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Entity Type | Organization
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Legal Business Name | ALPHA SPEECH & LANGUAGE CENTER
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Dates
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Enumeration Date | 10/08/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2642 GLENWOOD PARK AVE
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City | ERIE
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State | PA
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Zip | 16508-1811
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Country | US
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Telephone | 814-451-0940
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Fax | 814-451-0940
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Provider Business Mailing Address
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Address Line | 2642 GLENWOOD PARK AVE
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City | ERIE
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State | PA
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Zip | 16508-1811
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Country | US
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Telephone | 814-451-0940
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Fax | 814-451-0940
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Authorized Official
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Title or Position | DIRECTOR
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Name | KAREN SHEPPARD
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Credential | M.A., CCC-SLP
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Telephone | 814-451-0940
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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 | SL002438L
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License Number State | PA
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