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General NPI Number Information
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NPI Number | 1568629590
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Entity Type | Organization
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Legal Business Name | RENAISSANCE LEARNING CTR
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 5800 CORPORATE WAY
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City | WEST PALM BEACH
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State | FL
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Zip | 33407
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Country | US
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Telephone | 561-640-0270
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Fax | 561-640-0271
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Provider Business Mailing Address
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Address Line | 5800 CORPORATE WAY
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City | WEST PALM BEACH
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State | FL
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Zip | 33407
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Country | US
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Telephone | 561-640-0270
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Fax | 561-640-0271
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. DEBRA JOHNSON
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Credential | MED
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Telephone | 561-640-0271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | FL
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