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General NPI Number Information
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NPI Number | 1023412152
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC CONNECTIONS L.L.C.
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 10/17/2014
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Provider Practice Location Address
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Address Line | 4566 E HIGHWAY 20 SUITE 205
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City | NICEVILLE
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State | FL
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Zip | 32578-8838
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Country | US
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Telephone | 504-274-9544
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Fax |
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Provider Business Mailing Address
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Address Line | 60 RED BAY CT
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-8011
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | CAROL E GARNER-HOUSTON
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Credential | OTR/L
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Telephone | 504-274-9544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 13046
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License Number State | FL
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