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General NPI Number Information
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NPI Number | 1083891907
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Entity Type | Organization
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Legal Business Name | LIFTING SPIRITS THERAPY SERVICES, INC
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Dates
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Enumeration Date | 01/22/2008
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Last Update Date | 03/31/2017
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Provider Practice Location Address
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Address Line | 500 SPRING ST SE STE 101
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City | GAINESVILLE
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State | GA
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Zip | 30501-3773
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Country | US
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Telephone | 770-615-7676
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Fax | 770-615-0177
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Provider Business Mailing Address
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Address Line | PO BOX 1071
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City | GAINESVILLE
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State | GA
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Zip | 30503-1071
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Country | US
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Telephone | 678-908-7057
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Fax | 770-536-9629
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST-OWNER
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Name | MISS YURIDIA GARZA
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Credential | MS OTR/L
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Telephone | 678-908-7057
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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 | OT006677
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | PT009992
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT005167
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT003657
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License Number State | GA
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