| Organization Name: | PROVIDENCE SPEECH & LANGUAGE SERVICES LLC |
| NPI Number: | 1841644812 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LESLEY S. SELMAN (PRESIDENT) |
| Mailing Address: | 3630 Northbrook Dr Suite D Northport |
| State: | AL US |
| Postal Code: | 354735822 |
| Phone Number: | 2052469345 |
| Fax Number: | |
| NPI Enumeration Date: | 04/15/2016 |
| NPI Last Update Date: | 04/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 3366 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| 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 |