=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952175150
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BIRMINGHAM LITERACY AND LANGUAGE SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/08/2023
-----------------------------------------------------
Last Update Date | 11/08/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 506 ONEAL DR
-----------------------------------------------------
City | HOOVER
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35226-2346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-907-9428
-----------------------------------------------------
Fax | 205-973-6014
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 506 ONEAL DR
-----------------------------------------------------
City | HOOVER
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35226-2346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-907-9428
-----------------------------------------------------
Fax | 205-973-6014
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/SPEECH LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | MRS. JUDITH HORNSBY CAPPS
-----------------------------------------------------
Credential | M.C.D, CCC-SLP
-----------------------------------------------------
Telephone | 205-907-9428
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0700X
-----------------------------------------------------
Taxonomy Name | Hearing and Speech Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------