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General NPI Number Information
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NPI Number | 1588717631
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Entity Type | Organization
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Legal Business Name | LANGUAGE LEARNING INTERVENTION & PROFESSIONAL SPEECH SERVICES, INC.
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Dates
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Enumeration Date | 01/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7433 GREENVILLE CIR
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City | LAKE WORTH
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State | FL
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Zip | 33467-7140
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Country | US
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Telephone | 561-313-7857
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Fax | 561-641-1481
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Provider Business Mailing Address
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Address Line | 7433 GREENVILLE CIR
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City | LAKE WORTH
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State | FL
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Zip | 33467-7140
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Country | US
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Telephone | 561-313-7857
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Fax | 561-641-1481
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MISTY LEANN WILLIAMS
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Credential | MS, CCC
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Telephone | 561-313-7857
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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 | SA 2460
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License Number State | FL
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