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General NPI Number Information
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NPI Number | 1588754808
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Entity Type | Organization
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Legal Business Name | OVER THE MOUNTAIN SPEECH, LANGUAGE, AND LEARNING SERVICES, LLC
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Dates
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Enumeration Date | 10/15/2006
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 4231 DOLLY RIDGE ROAD
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City | VESTAVIA HILLS
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State | AL
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Zip | 35243
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Country | US
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Telephone | 205-531-8998
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Fax | 205-970-4122
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Provider Business Mailing Address
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Address Line | 1050 LAKE COLONY LN
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City | VESTAVIA HILLS
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State | AL
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Zip | 35242-7405
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Country | US
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Telephone | 205-531-8998
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Fax | 205-970-4122
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Authorized Official
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Title or Position | SPEECH/LANGUAGE PATHOLOGIST
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Name | MRS. JERRI HENDRIX SMITH
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Credential | MCD, CCC-SLP
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Telephone | 205-531-8998
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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 | 922
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License Number State | AL
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