Organization Name: | CHILDREN'S TLC |
NPI Number: | 1134164528 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TRISHA M LARSON (BILLING COORDINATOR) |
Mailing Address: | 3101 Main Street Kansas City |
State: | MO US |
Postal Code: | 641111921 |
Phone Number: | 8167560780 |
Fax Number: | 8167561677 |
NPI Enumeration Date: | 06/18/2006 |
NPI Last Update Date: | 10/06/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2006014615 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |