Bloomington-Normal Speech Therapy LLC
NPI #1336745892 in Bloomington, Illinois
Provider Information
- NPI Number
- 1336745892
- Entity Type
- Organization
- Organization Name
- Bloomington-Normal Speech Therapy LLC
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- Dec 9, 2020
- Last Updated
- Dec 9, 2020
Practice Location
- Address
- 2416 E WASHINGTON ST STE C5
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61704-1629
- Phone
- (309) 830-5925
Authorized Official
- Name
- BASHA M ONTIVEROS, M.S., CCC-SLP
- Title
- OWNER
- Phone
- (309) 830-5925
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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