Organization Name: | PEDIATRIC THERAPY AND LEARNING CENTER OF THE NORTHSHORE, LLC |
NPI Number: | 1851687198 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KRISTINE MENARD (MANAGER) |
Mailing Address: | 201 Holiday Blvd Ste. 315 Covington |
State: | LA US |
Postal Code: | 704335088 |
Phone Number: | 9852943582 |
Fax Number: | |
NPI Enumeration Date: | 06/24/2011 |
NPI Last Update Date: | 06/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4981 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
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 |