# BUILDING BLOCKS PEDIATRIC THERAPY

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

## Provider details

- **NPI number:** 1952328742
- **Authorized official:** KELLIE R. ALLEN MS,CCC-SLP (OWNER/SPEECH LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (618) 401-2648

## Contact information

- **Practice address:** 8643 FRUIT RD, EDWARDSVILLE, IL 62025-6521
- **Practice address phone:** (618) 401-2648
- **Mailing address:** 8643 FRUIT RD, EDWARDSVILLE, IL 62025-6521
- **Mailing address phone:** (618) 401-2648

## Taxonomy

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

## Other

- **Enumeration date:** 07/16/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 06027704 | BLUS CROSS BLUE SHIELD | IL |