Healthcare Provider Details

I. General information

NPI: 1699644187
Provider Name (Legal Business Name): TOGETHER WE GROW PEDIATRIC THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11146 TIMMERMAN ST
QUANTICO VA
22134-4235
US

IV. Provider business mailing address

11146 TIMMERMAN ST
QUANTICO VA
22134-4235
US

V. Phone/Fax

Practice location:
  • Phone: 863-225-2656
  • Fax:
Mailing address:
  • Phone: 863-225-2656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: SYDNEY WHITE
Title or Position: OWNER
Credential:
Phone: 863-944-1011