Bloomington-Normal Speech Therapy LLC
Speech-Language Pathologist, in Bloomington, IL. Organization (NPI-2).
NPI number1336745892
StatusActive
Last updated in NPPESDec 9, 2020
Details
- NPI
- 1336745892
- Entity type
- Organization (NPI-2)
- Legal business name
- Bloomington-Normal Speech Therapy LLC
- Organization subpart
- No
- Enumeration date
- Dec 9, 2020
- Certification date
- Dec 9, 2020
- Last updated
- Dec 9, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | – | – | Yes |
Practice location
2416 E Washington St Ste C5Bloomington, IL 61704-1629
Phone 309-830-5925
Mailing address
2416 E Washington St Ste C5Bloomington, IL 61704-1629
Phone 309-830-5925
Authorized official
Basha M Ontiveros
Owner
3098305925
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All 71 Speech-Language Pathologist providers in Bloomington · All 2,449 providers in Bloomington
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