Provider Demographics
NPI:1447883699
Name:SPEECH LANGUAGE & LEARNING CENTER OF TN
Entity type:Organization
Organization Name:SPEECH LANGUAGE & LEARNING CENTER OF TN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:
Authorized Official - First Name:KYLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANSFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:931-231-5273
Mailing Address - Street 1:PO BOX 96
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-0096
Mailing Address - Country:US
Mailing Address - Phone:931-766-6374
Mailing Address - Fax:931-766-6433
Practice Address - Street 1:1311 S LOCUST AVE STE 101
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-4054
Practice Address - Country:US
Practice Address - Phone:931-766-6374
Practice Address - Fax:931-766-6433
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPEECH LANGUAGE & LEARNING CENTER OF TN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty