=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821312703
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LANGUAGE CONNECTIONS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2010
-----------------------------------------------------
Last Update Date | 03/23/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3700 KRISTI LAKE DR APT H 12
-----------------------------------------------------
City | JONESBORO
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72404-8391
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-316-0812
-----------------------------------------------------
Fax | 870-203-0226
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3700 KRISTI LAKE DR APT H 12
-----------------------------------------------------
City | JONESBORO
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72404-8391
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | CARSHINA VINCENT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 870-316-0812
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------