Provider Demographics
NPI:1942337118
Name:RIVER VALLEY SPEECH ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:RIVER VALLEY SPEECH ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:KRISTIN
Authorized Official - Last Name:ENGLERT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC SLP
Authorized Official - Phone:309-647-4254
Mailing Address - Street 1:24790 N COUNTY HIGHWAY 23
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:IL
Mailing Address - Zip Code:61520-8364
Mailing Address - Country:US
Mailing Address - Phone:309-647-4254
Mailing Address - Fax:309-647-4158
Practice Address - Street 1:24790 N COUNTY HIGHWAY 23
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:IL
Practice Address - Zip Code:61520-8364
Practice Address - Country:US
Practice Address - Phone:309-647-4254
Practice Address - Fax:309-647-4158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty