| Organization Name: | SLLCCNINC. |
| NPI Number: | 1538430541 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIMBERLY ANN BLACK (CO-DIRECTOR) |
| Mailing Address: | 281 Route 34 Ste 807 Colts Neck |
| State: | NJ US |
| Postal Code: | 077222440 |
| Phone Number: | 7327610005 |
| Fax Number: | 7327610075 |
| NPI Enumeration Date: | 01/23/2012 |
| NPI Last Update Date: | 01/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 41YS00271800 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| 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 |