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General NPI Number Information
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NPI Number | 1447654447
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Entity Type | Organization
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Legal Business Name | WALK AND TALK PHYSICAL AND SPEECH THERAPY LLC
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Dates
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Enumeration Date | 10/20/2014
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Last Update Date | 10/20/2014
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Provider Practice Location Address
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Address Line | 2012 N MAIN ST
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City | CROWN POINT
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State | IN
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Zip | 46307-2002
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Country | US
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Telephone | 219-730-1153
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 CHURCHILL LN
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City | CROWN POINT
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State | IN
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Zip | 46307-5068
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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 | PHYSICAL THERAPIST
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Name | BARBARA VANDERWOUDE
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Credential |
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Telephone | 219-730-1153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 22004212A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05004131A
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License Number State | IN
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