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General NPI Number Information
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NPI Number | 1710454392
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Entity Type | Organization
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Legal Business Name | ASSISTIVE LEARNING TECHNOLOGY CONSULTING LLC
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Dates
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Enumeration Date | 10/31/2018
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Last Update Date | 10/31/2018
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Provider Practice Location Address
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Address Line | 918 NW RAINTREE DR
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City | CORVALLIS
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State | OR
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Zip | 97330-9769
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Country | US
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Telephone | 541-862-1480
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Fax |
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Provider Business Mailing Address
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Address Line | 922 NW CIRCLE BLVD STE 160-199
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City | CORVALLIS
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State | OR
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Zip | 97330-1483
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Country | US
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Telephone | 541-862-1480
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Fax |
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Authorized Official
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Title or Position | CONSULTANT/TRAINER/ADVOCATE
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Name | MRS. KENDRA KATHERINE WOLLERT
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Credential |
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Telephone | 541-862-1480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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