Provider Demographics
NPI:1902048036
Name:INSTITUTE FOR LEARNING AND DEVELOPMENT
Entity Type:Organization
Organization Name:INSTITUTE FOR LEARNING AND DEVELOPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:FELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:781-861-3711
Mailing Address - Street 1:4 MILITIA DR STE 20
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-4705
Mailing Address - Country:US
Mailing Address - Phone:781-861-3711
Mailing Address - Fax:781-861-3701
Practice Address - Street 1:4 MILITIA DR STE 20
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-4705
Practice Address - Country:US
Practice Address - Phone:781-861-3711
Practice Address - Fax:781-861-3701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6640235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty