Provider Demographics
NPI:1598318974
Name:BUILDING BLOCKS THERAPY CLINIC
Entity Type:Organization
Organization Name:BUILDING BLOCKS THERAPY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/SPEECH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:MS/CCC-SLP
Authorized Official - Phone:270-240-5051
Mailing Address - Street 1:724 HARVARD DR
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-6152
Mailing Address - Country:US
Mailing Address - Phone:270-240-5051
Mailing Address - Fax:
Practice Address - Street 1:724 HARVARD DR
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-6152
Practice Address - Country:US
Practice Address - Phone:270-240-5051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-24
Last Update Date:2020-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
1215006515OtherNPI