Healthcare Provider Details

I. General information

NPI: 1922426014
Provider Name (Legal Business Name): THERAPY CONNECTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2014
Last Update Date: 04/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WINDSWEPT DR
NASHVILLE IL
62263-5048
US

IV. Provider business mailing address

3 WINDSWEPT DR
NASHVILLE IL
62263-5048
US

V. Phone/Fax

Practice location:
  • Phone: 618-237-2214
  • Fax: 618-327-9970
Mailing address:
  • Phone: 618-237-2214
  • Fax: 618-327-9970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number070007175
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number070007159
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number070006379
License Number StateIL

VIII. Authorized Official

Name: MRS. NANCY VERHINES
Title or Position: PT
Credential: PT
Phone: 618-237-2214