Healthcare Provider Details

I. General information

NPI: 1255162947
Provider Name (Legal Business Name): RAISING ARROWS THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2024
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 DANIELS RD
WINTER GARDEN FL
34787-4376
US

IV. Provider business mailing address

1855 PARTIN TERRACE RD
KINDRED FL
34744-6062
US

V. Phone/Fax

Practice location:
  • Phone: 407-395-9976
  • Fax:
Mailing address:
  • Phone: 386-337-4016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: ANA MARIE JANUARY
Title or Position: OWNER
Credential:
Phone: 321-754-0686