Intercept Speech And Language, LLC
Day Training, Developmentally Disabled Services in Sierra Vista, AZ. Organization (NPI-2).
NPI number1679656409
StatusActive
Last updated in NPPESJul 8, 2009
Details
- NPI
- 1679656409
- Entity type
- Organization (NPI-2)
- Legal business name
- Intercept Speech And Language, LLC
- Organization subpart
- No
- Enumeration date
- Oct 23, 2006
- Last updated
- Jul 8, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251C00000X | Day Training, Developmentally Disabled Services | SLP4673 | AZ | Yes |
Practice location
1201 E Fry BlvdSuite #1
Sierra Vista, AZ 85635-2600
Phone 520-459-8258 · Fax 520-459-8619
Mailing address
13428 Maxella Ave # 228Marina Del Rey, CA 90292-5620
Phone 520-459-8258 · Fax 520-459-8619
Authorized official
Corneta E. Kelley
Owner
5204598258
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