Provider Demographics
NPI:1962529743
Name:TODDLER TALK, INC.
Entity type:Organization
Organization Name:TODDLER TALK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUTACHOUIK
Authorized Official - Suffix:
Authorized Official - Credentials:MED, CCC-SLP
Authorized Official - Phone:502-299-4926
Mailing Address - Street 1:8922 ZABEL WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-1553
Mailing Address - Country:US
Mailing Address - Phone:502-299-4926
Mailing Address - Fax:502-690-4363
Practice Address - Street 1:8922 ZABEL WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-1553
Practice Address - Country:US
Practice Address - Phone:502-299-4926
Practice Address - Fax:502-690-4363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-25
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2170252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency