Provider Demographics
NPI:1245592021
Name:PROGRESSIVE SPEECH THERAPY
Entity Type:Organization
Organization Name:PROGRESSIVE SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR, SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:POOJA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP
Authorized Official - Phone:571-246-6495
Mailing Address - Street 1:44121 HARRY BYRD HWY
Mailing Address - Street 2:SUITE 255
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5667
Mailing Address - Country:US
Mailing Address - Phone:571-246-6495
Mailing Address - Fax:
Practice Address - Street 1:44121 HARRY BYRD HWY
Practice Address - Street 2:SUITE 255
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5667
Practice Address - Country:US
Practice Address - Phone:571-246-6495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004866235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty