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Organization
SWIM LEARN PLAY
Active
Organization
SWIM LEARN PLAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BREANNA CAPEL M.S.,CCC-SLP/L (CO-OWNER)
(828) 712-2012
Entity
Organization
Contact information
Practice address
6201 JOLIET RD, COUNTRYSIDE, IL 60525-3958
(312) 725-9050
Mailing address
400 N MCCLURG CT APT 3214, CHICAGO, IL 60611-4386
(828) 712-2012
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437827789
IMPACT
IL
01
—
1669140331
IMPACT
—
Enumeration date
09/22/2023
Last updated
09/22/2023
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