Provider Demographics
NPI:1245734037
Name:GROW & PLAY PEDIATRIC THERAPY, LLC
Entity Type:Organization
Organization Name:GROW & PLAY PEDIATRIC THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-369-9668
Mailing Address - Street 1:1211 SPRINGHILL LN
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-1757
Mailing Address - Country:US
Mailing Address - Phone:484-369-9668
Mailing Address - Fax:
Practice Address - Street 1:1211 SPRINGHILL LN
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-1757
Practice Address - Country:US
Practice Address - Phone:484-369-9668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009465235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty