Provider Demographics
NPI:1194455840
Name:PEDIATRIC THERAPY GARDEN
Entity Type:Organization
Organization Name:PEDIATRIC THERAPY GARDEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LEANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-345-8222
Mailing Address - Street 1:429 SOUTHING GRANGE
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53527-9336
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:429 SOUTHING GRANGE
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:WI
Practice Address - Zip Code:53527-9336
Practice Address - Country:US
Practice Address - Phone:608-345-8222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty