Provider Demographics
NPI:1457166134
Name:THRIVE PEDIATRIC SPEECH THERAPY, LLC
Entity type:Organization
Organization Name:THRIVE PEDIATRIC SPEECH THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:719-469-3431
Mailing Address - Street 1:317 W 3RD ST STE 204
Mailing Address - Street 2:
Mailing Address - City:LA JUNTA
Mailing Address - State:CO
Mailing Address - Zip Code:81050-1401
Mailing Address - Country:US
Mailing Address - Phone:719-469-3431
Mailing Address - Fax:
Practice Address - Street 1:28821 COUNTY ROAD 20.5
Practice Address - Street 2:
Practice Address - City:ROCKY FORD
Practice Address - State:CO
Practice Address - Zip Code:81067-9447
Practice Address - Country:US
Practice Address - Phone:719-469-3431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty