Healthcare Provider Details
I. General information
NPI: 1609187178
Provider Name (Legal Business Name): CAROLINA THERAPY CONNECTION, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2010
Last Update Date: 04/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1925A TURNBURY DR
GREENVILLE NC
27858-6168
US
IV. Provider business mailing address
1925A TURNBURY DR
GREENVILLE NC
27858-6168
US
V. Phone/Fax
- Phone: 252-341-9944
- Fax: 252-439-0957
- Phone: 252-341-9944
- Fax: 252-439-0957
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251P0200X |
| Taxonomy | Pediatric Physical Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
CYNTHIA
ANN
TAYLOR
Title or Position: OWNER
Credential: MS, OTR/L
Phone: 252-814-8134