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General NPI Number Information
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NPI Number | 1073368775
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Entity Type | Organization
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Legal Business Name | DIVERGENT THERAPY SERVICES LLC
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Dates
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Enumeration Date | 04/17/2024
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 1976 GADSDEN HWY STE 208
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City | BIRMINGHAM
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State | AL
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Zip | 35235-3266
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Country | US
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Telephone | 256-283-1891
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Fax |
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Provider Business Mailing Address
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Address Line | 101 CAHABA FOREST DR
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City | TRUSSVILLE
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State | AL
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Zip | 35173-2083
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Country | US
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Telephone | 256-283-1891
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ABBY HEDGEPATH
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Credential |
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Telephone | 256-283-1891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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