=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366797516
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEAR-2-LEARN
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2012
-----------------------------------------------------
Last Update Date | 07/13/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2 HOPKINS RD APT 3
-----------------------------------------------------
City | LIVERPOOL
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13088-5737
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-876-1089
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2 HOPKINS RD APT 3
-----------------------------------------------------
City | LIVERPOOL
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13088-5737
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-876-1089
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPECIAL EDUCATOR
-----------------------------------------------------
Name | MS. MARTHA ELENA RODRIGUEZ
-----------------------------------------------------
Credential | MS., ED
-----------------------------------------------------
Telephone | 315-876-1089
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number | 076322011
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------