Provider Demographics
NPI:1265577696
Name:PROGRESSIVE DEVELOPMENT THERAPY
Entity type:Organization
Organization Name:PROGRESSIVE DEVELOPMENT THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP - OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:501-223-8838
Mailing Address - Street 1:2011 HILLSBOROUGH LN
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-3730
Mailing Address - Country:US
Mailing Address - Phone:501-223-8838
Mailing Address - Fax:501-562-0327
Practice Address - Street 1:2011 HILLSBOROUGH LN
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-3730
Practice Address - Country:US
Practice Address - Phone:501-223-8838
Practice Address - Fax:501-562-0327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty