Basic Information
| Provider Information | |||||||||
| NPI: | 1528699428 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TALK 'N PLAY THERAPY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 812 SCOTT CT | ||||||||
| Address2: | |||||||||
| City: | PICKERINGTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431478353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143072372 | ||||||||
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| Practice Location | |||||||||
| Address1: | 812 SCOTT CT | ||||||||
| Address2: | |||||||||
| City: | PICKERINGTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431478353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143072372 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2020 | ||||||||
| LastUpdateDate: | 01/29/2020 | ||||||||
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| AuthorizedOfficialLastName: | MILLER | ||||||||
| AuthorizedOfficialFirstName: | VANESSA | ||||||||
| AuthorizedOfficialMiddleName: | RENE | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO AND SPEECH-LANGUAGE PATHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 6143072372 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | MA CCC-SLP | ||||||||
| NPICertificationDate: | 01/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.