Provider Demographics
NPI:1386081917
Name:TLC SPEECH & LANGUAGE THERAPY, INC
Entity type:Organization
Organization Name:TLC SPEECH & LANGUAGE THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:719-641-9802
Mailing Address - Street 1:8373 ANDRUS DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-8044
Mailing Address - Country:US
Mailing Address - Phone:719-641-9802
Mailing Address - Fax:732-595-9751
Practice Address - Street 1:8373 ANDRUS DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-8044
Practice Address - Country:US
Practice Address - Phone:719-641-9802
Practice Address - Fax:732-595-9751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12037576261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO79884580Medicaid