Provider Demographics
NPI:1053394007
Name:THE SPEECH LANGUAGE & LEARNING CENTER LLC
Entity type:Organization
Organization Name:THE SPEECH LANGUAGE & LEARNING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:M
Authorized Official - Last Name:PHILPOT
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCS SLP
Authorized Official - Phone:931-766-6374
Mailing Address - Street 1:909 N LOCUST AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-2871
Mailing Address - Country:US
Mailing Address - Phone:931-766-6374
Mailing Address - Fax:931-766-6433
Practice Address - Street 1:909 N LOCUST AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-2871
Practice Address - Country:US
Practice Address - Phone:931-766-6374
Practice Address - Fax:931-766-6433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 225X00000X
TNSP530235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4055213OtherBCBST