Willow Tree Speech Therapy

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

WILLOW TREE SPEECH THERAPY

Practice address

133 Waters Edge Dr
Waterloo, IL 62298-0108

Phone

(618) 541-4609

NPI assigned

Feb 20, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elizabeth HornNPI 1669985073

Title

Owner/Speech Language Pathologist

Phone

(618) 541-4609

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth Horn

  • Speech-Language Pathologist
  • Belleville, IL
  • NPI 1669985073
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1700419546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 DANUBE",
            "city": "MILLSTADT",
            "state": "IL",
            "postal_code": "622602255",
            "telephone_number": "618-541-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 WATERS EDGE DR",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622980108",
            "telephone_number": "618-541-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW TREE SPEECH THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "HORN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER/SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "618-541-4609"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "speech@willowtreespeechtherapy.com",
            "affiliation": "N",
            "endpointDescription": "Gsuit Email",
            "address_1": "133 Waters Edge Dr",
            "city": "Waterloo",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622980108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Debra Wilkerson, LPN
• Tyra Christine Williams, RSA
• Jacqueline Ellen Wilson, MAQMHP
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• Shanna Witges, APRN NP-C
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• Speech-Language Pathologist in Waterloo, IL
• Providers in Waterloo, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.