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Organization
SPEECH LANGUAGE FUNDAMENTALS INC
Active
Organization
SPEECH LANGUAGE FUNDAMENTALS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA MARIE GOFORTH MHS CCC-SLP/L (DIRECTOR OF SERVICES/OWNER)
(708) 299-4799
Entity
Organization
Contact information
Practice address
2923 198TH PL, LYNWOOD, IL 60411-4546
(708) 299-4799
Mailing address
2923 198TH PL, LYNWOOD, IL 60411-4546
(708) 299-4799
(708) 849-6079
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146007330
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001633463
BCBS
—
Enumeration date
11/29/2006
Last updated
08/27/2009
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