Healthcare Provider Details

I. General information

NPI: 1326812520
Provider Name (Legal Business Name): WOVEN WORDS THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2023
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 GLEN ED PROFESSIONAL PARK STE B
GLEN CARBON IL
62034-3305
US

IV. Provider business mailing address

6201 SWORM LN
EDWARDSVILLE IL
62025-4917
US

V. Phone/Fax

Practice location:
  • Phone: 618-698-0369
  • Fax:
Mailing address:
  • Phone: 618-698-0369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. NATASHA STELLHORN
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: CCC-SLP
Phone: 618-698-0369