Innovative Therapy Services

NPI 1134460363 - Early Intervention Provider Agency - 252Y00000X

NPI Details
NPI 1134460363
Enumeration Date 03/13/2013
Last Updated 03/13/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name TASHA MICHELLE TASHA
Position SPEECH PATHOLOGIST
Phone (301) 646-0304
Fax
Practice Location
632 TAHOE CIR
STONE MOUNTAIN GA, 30083-4450, US
Phone (301) 646-0304
Fax
Business Location
632 TAHOE CIR
STONE MOUNTAIN GA, 30083-4450, US
Phone (301) 646-0304
Fax
Toxanomy
Taxonomy Code 252Y00000X
License State Georgia
License Number SLP007594
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According to our database, Innovative Therapy Services NPI is 1134460363, taxonomy code is 252Y00000X and license number is SLP007594, license state is located at Georgia. Innovative Therapy Services physically located at 632 Tahoe Cir, Stone Mountain GA, 30083-4450. NPI Number 1033115704 has the healthcare provider type.

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1134460363 NPI number is provided on an as is basis without warranty of any kind. 1134460363 is maintained by the National Plan & Provider Enumeration System. The contents of Innovative Therapy Services are for informational purposes only.