Healthcare Provider Details

I. General information

NPI: 1548198369
Provider Name (Legal Business Name): FOUNDATIONS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 CHESAPEAKE AVE UNIT 3004
ANNAPOLIS MD
21403-3250
US

IV. Provider business mailing address

821 CHESAPEAKE AVE UNIT 3004
ANNAPOLIS MD
21403-3250
US

V. Phone/Fax

Practice location:
  • Phone: 301-356-0862
  • Fax:
Mailing address:
  • Phone: 301-356-0862
  • 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: THEMBI DEPASS
Title or Position: CEO
Credential:
Phone: 301-356-0862