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General NPI Number Information
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NPI Number | 1265699110
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Entity Type | Organization
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Legal Business Name | BUILDING BLOCKS THERAPY, LTD.
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 12/19/2016
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Provider Practice Location Address
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Address Line | 415 WILLIAMSBURG AVE
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City | GENEVA
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State | IL
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Zip | 60134-1091
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Country | US
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Telephone | 331-248-0251
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Fax | 331-248-0252
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Provider Business Mailing Address
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Address Line | 643 THOMPSON AVE
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City | NORTH AURORA
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State | IL
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Zip | 60542-9128
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Country | US
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Telephone | 847-343-8109
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Fax | 630-701-2327
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Authorized Official
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Title or Position | OWNER/SPEECH LANGAUGE PATHOLOGIST
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Name | SARAH A WASSERBERG
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Credential | MA CCC-SLP/L
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Telephone | 847-343-8109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 146006763
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License Number State | IL
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