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General NPI Number Information
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NPI Number | 1558181248
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Entity Type | Organization
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Legal Business Name | 3RD GENERATION THERAPIES LLC
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 7030 CENTENNIAL DR STE 158
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City | TINLEY PARK
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State | IL
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Zip | 60477-1649
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Country | US
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Telephone | 708-822-2623
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Fax |
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Provider Business Mailing Address
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Address Line | 7030 CENTENNIAL DR STE 158
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City | TINLEY PARK
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State | IL
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Zip | 60477-1649
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Country | US
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Telephone | 708-822-2623
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Fax |
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Authorized Official
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Title or Position | OWNER/SPEECH-LANGUAGE PATHOLOGIST
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Name | MR. JOSEPH ROBERT SIERRA III
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Credential | M.H.S., CCC-SLP/L
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Telephone | 708-822-2623
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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 |
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License Number State |
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