MEDICARE: FOUR FARTHINGS THERAPY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1013717735
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUR FARTHINGS THERAPY, PLLC

Provider Business Mailing Address
First Line	:	192 ISLAND LOOP
Second Line	:
City	:	ROCK ISLAND
State	:	WA
Zip	:	98850-9304
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	192 ISLAND LOOP
Second Line	:
City	:	ROCK ISLAND
State	:	WA
Zip	:	98850-9304
Country	:	US
Telephone Number	:	509-429-2953
Fax Number	:

Authorized Official
Title or Position	:	SPEECH LANGUAGE PATHOLOGIST
Name	:	ANNA MUNSEY-RISELEY
Credential	:	CCC-SLP
Telephone Number	:	509-429-2953

Provider Enumeration Date	:	03/13/2025
Last Update Date	:	03/13/2025

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