MEDICARE: PROGRESSIVE DEVELOPMENT THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1265577696
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROGRESSIVE DEVELOPMENT THERAPY

Provider Business Mailing Address
First Line	:	2011 HILLSBOROUGH LN
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72212-3730
Country	:	US
Telephone Number	:	501-223-8838
Fax Number	:	501-562-0327

Provider Business Practice Location Address
First Line	:	2011 HILLSBOROUGH LN
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72212-3730
Country	:	US
Telephone Number	:	501-223-8838
Fax Number	:	501-562-0327

Authorized Official
Title or Position	:	SLP - OWNER
Name	:	JANA FOLEY
Credential	:	MS CCC-SLP
Telephone Number	:	501-223-8838

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	04/15/2008

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Directions to “PROGRESSIVE DEVELOPMENT THERAPY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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