Healthcare Provider Details

I. General information

NPI: 1669393062
Provider Name (Legal Business Name): THE AFFIRM THERAPY COLAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9227 CROOKED RD
LINCOLN DE
19960-3964
US

IV. Provider business mailing address

9227 CROOKED RD
LINCOLN DE
19960-3964
US

V. Phone/Fax

Practice location:
  • Phone: 302-260-2257
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: TERESA JACKSON
Title or Position: OWNER/MANAGER
Credential:
Phone: 302-260-2257