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General NPI Number Information
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NPI Number | 1104637768
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Entity Type | Organization
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Legal Business Name | WILLOW THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 233 S PLEASANT GROVE BLVD STE 201
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-2878
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Country | US
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Telephone | 801-753-8193
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Fax |
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Provider Business Mailing Address
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Address Line | 233 S PLEASANT GROVE BLVD STE 201
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-2878
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST/OWNER
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Name | COURTNEY SCHNEIDER
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Credential | MS SLP
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Telephone | 385-277-8685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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