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General NPI Number Information
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NPI Number | 1144822826
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Entity Type | Organization
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Legal Business Name | ANYTHING BUT ORDINARY THERAPY GROUP PLLC
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Dates
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Enumeration Date | 11/09/2020
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Last Update Date | 11/09/2020
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Provider Practice Location Address
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Address Line | 6330 NEWTOWN RD STE 509
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City | NORFOLK
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State | VA
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Zip | 23502-4808
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Country | US
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Telephone | 757-449-2557
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Fax |
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Provider Business Mailing Address
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Address Line | 727 DELAWARE AVE
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City | NORFOLK
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State | VA
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Zip | 23508-2813
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Country | US
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Telephone | 757-449-2557
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Fax |
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Authorized Official
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Title or Position | OWNER/SPEECH LANGUAGE PATHOLOGIST
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Name | JENNIFER TAYLOR
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Credential | M.S., CCC-SLP
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Telephone | 757-449-2557
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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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