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General NPI Number Information
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NPI Number | 1205306115
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Entity Type | Organization
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Legal Business Name | THE PARENTING PLACE
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Dates
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Enumeration Date | 12/04/2018
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Last Update Date | 01/08/2019
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Provider Practice Location Address
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Address Line | 1500 GREEN BAY ST
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City | LA CROSSE
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State | WI
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Zip | 54601-6455
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Country | US
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Telephone | 608-784-8125
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Fax | 608-796-0098
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Provider Business Mailing Address
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Address Line | 1500 GREEN BAY ST
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City | LA CROSSE
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State | WI
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Zip | 54601-6455
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Country | US
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Telephone | 608-784-8125
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Fax | 608-796-0098
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JODI WIDUCH
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Credential |
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Telephone | 608-784-8125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical 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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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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 | 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 #4
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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