# IGNITE PEDIATRIC THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ignite Pediatric Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083375604
- **Authorized official:** MRS. MAURA AMBROSE CCC-SLP (CEO/OWNER)
- **Authorized official phone:** (814) 873-4763

## Contact information

- **Practice address:** 195 SPINNAKER DR, COLUMBIANA, OH 44408-9666
- **Practice address phone:** (814) 873-4763
- **Mailing address:** 195 SPINNAKER DR, COLUMBIANA, OH 44408-9666
- **Mailing address phone:** (814) 873-4763

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 235Z00000X | Speech-Language Pathologist | — | — | Yes |

## Other

- **Enumeration date:** 01/05/2022
- **Last updated:** 01/05/2022