Organization
TINY TOTS THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CORRIN REIMER (SPEECH LANGUAGE PATHOLOGIST)
(217) 412-0616
Entity
Organization
Contact information
Practice address
RR 2 BOX 154B, SHELBYVILLE, IL 62565-8237
(217) 412-0616
Mailing address
RR 2 BOX 154B, SHELBYVILLE, IL 62565-8237
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
146010364
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578875019
NPI TYPE 1
IL
05
—
352704130001
—
IL
Enumeration date
08/30/2010
Last updated
08/30/2010
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