Healthcare Provider Details

I. General information

NPI: 1730925561
Provider Name (Legal Business Name): THERAPY MANAGEMENT GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2024
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10587 DOUBLE R BLVD STE 101
RENO NV
89521-8966
US

IV. Provider business mailing address

8020 W SAHARA AVE STE 160
LAS VEGAS NV
89117-7917
US

V. Phone/Fax

Practice location:
  • Phone: 702-595-5437
  • Fax: 702-425-2787
Mailing address:
  • Phone: 702-595-5437
  • Fax: 702-425-2787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MARNIE ANNE LANCZ
Title or Position: DIRECTOR
Credential:
Phone: 702-556-3132