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NPI Code Detail

MEDICARE: BUILDING BLOCKS THERAPY CLINIC

MEDICARE: BUILDING BLOCKS THERAPY CLINIC
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
1252Y00000XEarly Intervention Provider Agency
2261QM1300XMulti-Specialty Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11215006515OTHERNPI

General Provider Information

NPI Number : 1598318974
Entity Type Code : Organization
Provider Name (Legal Business Name) : BUILDING BLOCKS THERAPY CLINIC
Provider Business Mailing Address
First Line : 724 HARVARD DR
Second Line :
City : OWENSBORO
State : KY
Zip : 42301-6152
Country : US
Telephone Number : 270-240-5051
Fax Number :
Provider Business Practice Location Address
First Line : 724 HARVARD DR
Second Line :
City : OWENSBORO
State : KY
Zip : 42301-6152
Country : US
Telephone Number : 270-240-5051
Fax Number :
Authorized Official
Title or Position : MEMBER/SPEECH THERAPIST
Name : TONYA D WOODS
Credential : MS/CCC-SLP
Telephone Number : 270-240-5051
Provider Enumeration Date : 07/24/2019
Last Update Date : 04/25/2020

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Directions to “BUILDING BLOCKS THERAPY CLINIC ” Practice Location

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