Organization
CHILDHOOD POTENTIALS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENISE ANN HOWARD MHS, CCC-SLP/L (SPEECH PATHOLOGIST, PRESIDENT)
(815) 370-4812
Entity
Organization
Contact information
Practice address
101 OLD FARM MIDDLE CT, BRADLEY, IL 60915-1485
(815) 932-4812
(815) 936-9077
Mailing address
101 OLD FARM MIDDLE CT, BRADLEY, IL 60915-1485
(815) 932-4812
(815) 936-9077
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4632010
BCBS
IL
Enumeration date
08/07/2006
Last updated
01/16/2008
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