Provider Demographics
NPI:1063577724
Name:THERAPY LEARNING CENTER, LLC
Entity type:Organization
Organization Name:THERAPY LEARNING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:DIX
Authorized Official - Last Name:JIVIDEN
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:513-934-1226
Mailing Address - Street 1:986 BELVEDERE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-2890
Mailing Address - Country:US
Mailing Address - Phone:513-934-1226
Mailing Address - Fax:513-934-1227
Practice Address - Street 1:986 BELVEDERE DR
Practice Address - Street 2:SUITE B
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-2890
Practice Address - Country:US
Practice Address - Phone:513-934-1226
Practice Address - Fax:513-934-1227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT - O1610174400000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty