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General NPI Number Information
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NPI Number | 1861535064
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Entity Type | Organization
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Legal Business Name | LISTEN AND LEARN AUDITORY-VERBAL COMMUNICATION CENTER, INC.
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 412 NOBBE LN
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City | INDIANAPOLIS
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State | IN
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Zip | 46239-9469
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Country | US
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Telephone | 317-894-5554
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Fax | 317-894-5554
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Provider Business Mailing Address
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Address Line | 412 NOBBE LN
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City | INDIANAPOLIS
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State | IN
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Zip | 46239-9469
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Country | US
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Telephone | 317-894-5554
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Fax | 317-894-5554
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARY BOUCHER JONES
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Credential | M.A., CED, CCC-SLP,
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Telephone | 317-894-5554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 22002251A
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License Number State | IN
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