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General NPI Number Information
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NPI Number | 1457844409
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Entity Type | Organization
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Legal Business Name | THE LANGUAGE LITERACY DOCTOR
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Dates
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Enumeration Date | 06/13/2018
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Last Update Date | 06/13/2018
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Provider Practice Location Address
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Address Line | 913 FIRST COLONIAL RD STE 204
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3198
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Country | US
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Telephone | 757-632-0704
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Fax | 855-632-4964
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Provider Business Mailing Address
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Address Line | 913 FIRST COLONIAL RD STE 204
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3198
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Country | US
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Telephone | 757-632-0704
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Fax | 855-632-4964
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST/OWNER
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Name | DR. CINDY CONCA
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Credential | EDDCCC/SLP
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Telephone | 757-632-0704
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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 | 2202007227
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License Number State | VA
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