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General NPI Number Information
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NPI Number | 1386081917
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Entity Type | Organization
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Legal Business Name | TLC SPEECH & LANGUAGE THERAPY, INC
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Dates
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Enumeration Date | 05/22/2013
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Last Update Date | 05/22/2013
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Provider Practice Location Address
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Address Line | 8373 ANDRUS DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-8044
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Country | US
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Telephone | 719-641-9802
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Fax | 732-595-9751
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Provider Business Mailing Address
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Address Line | 8373 ANDRUS DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-8044
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Country | US
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Telephone | 719-641-9802
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Fax | 732-595-9751
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST/OWNER
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Name | TONYA JONES
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Credential | MS CCC-SLP
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Telephone | 719-641-9802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 12037576
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License Number State | CO
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