Innovative Therapy LLC
Speech-Language Pathologist, in Virginia Beach, VA. Organization (NPI-2).
NPI number1982208781
StatusActive
Last updated in NPPESJul 9, 2021
Details
- NPI
- 1982208781
- Entity type
- Organization (NPI-2)
- Legal business name
- Innovative Therapy LLC
- Organization subpart
- No
- Enumeration date
- Nov 23, 2020
- Certification date
- Jul 9, 2021
- Last updated
- Jul 9, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | – | – | Yes |
| 103K00000X | Behavior Analyst | – | – | |
| 225X00000X | Occupational Therapist | – | – | |
| 225XP0200X | Occupational Therapist, Pediatrics | – | – |
Other names
- Innovative Therapy (Doing Business As)
Practice location
900 Commonwealth Place, Suite 365Virginia Beach, VA 23464
Phone 757-373-2023 · Fax 757-447-0139
Mailing address
900 Commonwealth Place, Suite 365Virginia Beach, VA 23464
Phone 757-373-2023 · Fax 757-447-0139
Authorized official
Lindsey Grace Gleason
Owner/Managing Partner
7574500977
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