Provider Demographics
NPI:1285623496
Name:LANGUAGE LEARNING TECHNOLOGIES, LTD
Entity type:Organization
Organization Name:LANGUAGE LEARNING TECHNOLOGIES, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:PHELAN
Authorized Official - Last Name:GOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:CCC SLP
Authorized Official - Phone:248-816-7000
Mailing Address - Street 1:1635 W BIG BEAVER RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3501
Mailing Address - Country:US
Mailing Address - Phone:248-816-7000
Mailing Address - Fax:248-816-8040
Practice Address - Street 1:1635 W BIG BEAVER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3501
Practice Address - Country:US
Practice Address - Phone:248-816-7000
Practice Address - Fax:248-816-8040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty