Provider Demographics
NPI:1144531534
Name:SECOND LANGUAGE LITERACY LEARNING CONNECTION
Entity type:Organization
Organization Name:SECOND LANGUAGE LITERACY LEARNING CONNECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO SLLLC
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:CHITESTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:732-642-5118
Mailing Address - Street 1:107 NEWMAN CT
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-5198
Mailing Address - Country:US
Mailing Address - Phone:732-642-5118
Mailing Address - Fax:
Practice Address - Street 1:107 NEWMAN CT
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-5198
Practice Address - Country:US
Practice Address - Phone:732-642-5118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00460500252Y00000X, 235Z00000X
252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty