Provider Demographics
NPI:1295208379
Name:WAY TO GROW PEDIATRIC THERAPY INC
Entity type:Organization
Organization Name:WAY TO GROW PEDIATRIC THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP/L
Authorized Official - Phone:309-368-5272
Mailing Address - Street 1:5601 BROOKMERE ST
Mailing Address - Street 2:
Mailing Address - City:EDWARDS
Mailing Address - State:IL
Mailing Address - Zip Code:61528-9408
Mailing Address - Country:US
Mailing Address - Phone:309-368-5272
Mailing Address - Fax:309-966-3621
Practice Address - Street 1:5601 BROOKMERE ST
Practice Address - Street 2:
Practice Address - City:EDWARDS
Practice Address - State:IL
Practice Address - Zip Code:61528-9408
Practice Address - Country:US
Practice Address - Phone:309-368-5272
Practice Address - Fax:309-966-3621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty