# CHILDRENS CENTER FOR GROWTH AND DEVELOPMENT LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588926471
- **Authorized official:** MRS. BETH ANN ECONOMOU CCC-SLP (OWNER/SPEECH AND LANGUAGE PATHOLOGI)
- **Authorized official phone:** (810) 991-1211

## Contact information

- **Practice address:** 12319 HIGHLAND RD, SUITE 501, HARTLAND, MI 48353-2946
- **Practice address phone:** (810) 991-1211
- **Practice address fax:** (810) 991-6425
- **Mailing address:** 12319 HIGHLAND RD, SUITE 501, HARTLAND, MI 48353-2946
- **Mailing address phone:** (810) 991-1211
- **Mailing address fax:** (810) 991-6425

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | Yes |
| 235Z00000X | Speech-Language Pathologist | — | — | Yes |

## Other

- **Enumeration date:** 06/15/2012
- **Last updated:** 01/16/2013