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General NPI Number Information
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NPI Number | 1992208870
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Entity Type | Organization
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Legal Business Name | EMPOWERED, LLC
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Dates
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Enumeration Date | 03/16/2018
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Last Update Date | 03/16/2018
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Provider Practice Location Address
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Address Line | 2188 CRABTREE LN
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City | NORTHBROOK
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State | IL
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Zip | 60062-3518
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Country | US
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Telephone | 847-641-1051
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Fax |
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Provider Business Mailing Address
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Address Line | 2188 CRABTREE LN
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City | NORTHBROOK
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State | IL
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Zip | 60062-3518
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Country | US
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Telephone | 847-641-1051
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | MRS. HEATHER MIEHL
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Credential |
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Telephone | 847-641-1051
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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 | 146007611
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License Number State | IL
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