Provider Demographics
NPI:1841658283
Name:THE SPEECH AND LANGUAGE ADVOCACY CENTER
Entity type:Organization
Organization Name:THE SPEECH AND LANGUAGE ADVOCACY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TOULA
Authorized Official - Middle Name:CASSANDRA
Authorized Official - Last Name:ADU
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:734-315-0117
Mailing Address - Street 1:26045 RED WOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEW BOSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48164-9188
Mailing Address - Country:US
Mailing Address - Phone:734-315-0117
Mailing Address - Fax:
Practice Address - Street 1:26045 RED WOOD DR
Practice Address - Street 2:
Practice Address - City:NEW BOSTON
Practice Address - State:MI
Practice Address - Zip Code:48164-9188
Practice Address - Country:US
Practice Address - Phone:734-315-0117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-30
Last Update Date:2016-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101001234261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech