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General NPI Number Information
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NPI Number | 1356589022
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Entity Type | Organization
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Legal Business Name | CENTRAL COAST LANGUAGE AND LEARNING CENTER
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 787 MUNRAS AVE SUITE A
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City | MONTEREY
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State | CA
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Zip | 93940-3128
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Country | US
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Telephone | 831-645-7900
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Fax | 831-645-7906
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Provider Business Mailing Address
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Address Line | 787 MUNRAS AVE SUITE A
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City | MONTEREY
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State | CA
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Zip | 93940
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Country | US
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Telephone | 831-645-7900
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Fax | 831-645-7906
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Authorized Official
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Title or Position | DIRECTOR, SPEECH AND LANGUAGE
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Name | JENNIFER L D'ATTILIO
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Credential | MS, CCC-SLP
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Telephone | 831-645-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | SP13025
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License Number State | CA
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