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General NPI Number Information
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NPI Number | 1871940189
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Entity Type | Organization
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Legal Business Name | FACILITATING GROWTH
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 05/17/2016
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Provider Practice Location Address
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Address Line | 41 N MAIN ST STE 303
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City | WEST HARTFORD
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State | CT
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Zip | 06107-1929
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Country | US
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Telephone | 860-604-8119
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Fax |
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Provider Business Mailing Address
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Address Line | 41 N MAIN ST STE 303
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City | WEST HARTFORD
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State | CT
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Zip | 06107-1929
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Country | US
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Telephone | 860-604-8119
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Fax |
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Authorized Official
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Title or Position | SPEECH AND LANGUAGE PATHOLOGIST
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Name | LISA BETH LANGWEIL
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Credential | M.S.,CCC/SLP
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Telephone | 860-604-8119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 002504
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License Number State | CT
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