Provider Demographics
NPI:1194400531
Name:DC SPEECH LANGUAGE & LITERACY CENTER LLC
Entity type:Organization
Organization Name:DC SPEECH LANGUAGE & LITERACY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:GRANOFF
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:757-570-3200
Mailing Address - Street 1:2315 HUIDEKOPER PL NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-1825
Mailing Address - Country:US
Mailing Address - Phone:757-570-3200
Mailing Address - Fax:
Practice Address - Street 1:4545 42ND ST NW STE 211
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4623
Practice Address - Country:US
Practice Address - Phone:202-599-7518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty