Provider Demographics
NPI:1548360027
Name:HENDERSON SPEECH, HEARING & LANGUAGE CENTER, LLC
Entity type:Organization
Organization Name:HENDERSON SPEECH, HEARING & LANGUAGE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELISSA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP, MS SPED,
Authorized Official - Phone:702-733-8255
Mailing Address - Street 1:8560 S EASTERN AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2832
Mailing Address - Country:US
Mailing Address - Phone:702-733-8255
Mailing Address - Fax:
Practice Address - Street 1:8560 S EASTERN AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2832
Practice Address - Country:US
Practice Address - Phone:702-733-8255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty