Provider Demographics
NPI:1790985430
Name:CHENOWETH SPEECH THERAPY SERVICE, LLC
Entity Type:Organization
Organization Name:CHENOWETH SPEECH THERAPY SERVICE, LLC
Other - Org Name:THE CHILDREN'S THERAPY CENTER, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENOWETH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC/SLP
Authorized Official - Phone:304-636-4070
Mailing Address - Street 1:108 3RD ST
Mailing Address - Street 2:SUITE 26
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-3831
Mailing Address - Country:US
Mailing Address - Phone:304-636-4070
Mailing Address - Fax:304-636-4071
Practice Address - Street 1:108 3RD ST
Practice Address - Street 2:SUITE 26
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3831
Practice Address - Country:US
Practice Address - Phone:304-636-4070
Practice Address - Fax:304-636-4071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP-0795261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech