Healthcare Provider Details

I. General information

NPI: 1003211798
Provider Name (Legal Business Name): THERAPY UNLIMITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2014
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 MERCHANT ST STE 103
COLUMBIA MO
65203-5816
US

IV. Provider business mailing address

4200 MERCHANT ST STE 103
COLUMBIA MO
65203-5816
US

V. Phone/Fax

Practice location:
  • Phone: 573-777-8783
  • Fax: 573-777-8784
Mailing address:
  • Phone: 573-777-8783
  • Fax: 573-777-8784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number2006022412
License Number StateMO

VIII. Authorized Official

Name: LAURA POWELL
Title or Position: SPEECH PATHOLOGIST
Credential: MS CCC-SLP
Phone: 573-268-5014