Provider Demographics
NPI:1669056016
Name:PROGRESS NEURO LLC
Entity type:Organization
Organization Name:PROGRESS NEURO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:J
Authorized Official - Last Name:DISHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA/CCC-SLP
Authorized Official - Phone:937-303-4644
Mailing Address - Street 1:PO BOX 718
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:OH
Mailing Address - Zip Code:45303-0709
Mailing Address - Country:US
Mailing Address - Phone:937-303-4644
Mailing Address - Fax:
Practice Address - Street 1:409 W CANAL ST
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:OH
Practice Address - Zip Code:45303-5154
Practice Address - Country:US
Practice Address - Phone:937-303-4644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty