Provider Demographics
NPI:1417619719
Name:WHISPERING WILLOW SPEECH THERAPY
Entity Type:Organization
Organization Name:WHISPERING WILLOW SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH- LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MICKY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:918-384-8835
Mailing Address - Street 1:423 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:FORT SCOTT
Mailing Address - State:KS
Mailing Address - Zip Code:66701-1766
Mailing Address - Country:US
Mailing Address - Phone:918-384-8835
Mailing Address - Fax:620-390-3262
Practice Address - Street 1:5 E WALL ST
Practice Address - Street 2:
Practice Address - City:FORT SCOTT
Practice Address - State:KS
Practice Address - Zip Code:66701-1422
Practice Address - Country:US
Practice Address - Phone:918-384-8835
Practice Address - Fax:620-390-3262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-13
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty