Healthcare Provider Details

I. General information

NPI: 1033750955
Provider Name (Legal Business Name): TELG OCCUPATIONAL THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2019
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4703 NW 53RD AVE STE A2
GAINESVILLE FL
32653-3403
US

IV. Provider business mailing address

4703 NW 53RD AVE STE A2
GAINESVILLE FL
32653-3403
US

V. Phone/Fax

Practice location:
  • Phone: 352-332-6131
  • Fax: 352-332-6232
Mailing address:
  • Phone: 352-332-6131
  • Fax: 352-332-6232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: LINDSEY HELEN DHANS TELG
Title or Position: OWNER/OCCUPATIONAL THERAPIST
Credential: MOT, OTR/L
Phone: 352-332-6131