Provider Demographics
NPI:1942796859
Name:TODDLER WORLD SPEECH THERAPY
Entity Type:Organization
Organization Name:TODDLER WORLD SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:DAMARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:847-322-4645
Mailing Address - Street 1:13100 HEATHER MOSS DR APT 810
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-5537
Mailing Address - Country:US
Mailing Address - Phone:847-322-4645
Mailing Address - Fax:
Practice Address - Street 1:13100 HEATHER MOSS DR APT 810
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-5537
Practice Address - Country:US
Practice Address - Phone:847-322-4645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146010584235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty