Healthcare Provider Details

I. General information

NPI: 1881462737
Provider Name (Legal Business Name): EMPOWER THERAPY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2023
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3115 CIMARRON TRL
WEST COLUMBIA SC
29170-2749
US

IV. Provider business mailing address

PO BOX 2092
LEXINGTON SC
29071-2092
US

V. Phone/Fax

Practice location:
  • Phone: 803-292-4220
  • Fax:
Mailing address:
  • Phone: 803-292-4220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: SARAH NELL LADER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: BCBA
Phone: 803-292-4220