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General NPI Number Information
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NPI Number | 1215056478
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Entity Type | Organization
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Legal Business Name | TANDEM THERAPY SERVICES
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 06/22/2015
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Provider Practice Location Address
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Address Line | 7261 W CHARLESTON BLVD #101
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City | LAS VEGAS
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State | NV
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Zip | 89117-1636
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Country | US
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Telephone | 702-396-0101
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Fax | 702-222-0212
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Provider Business Mailing Address
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Address Line | 7261 W CHARLESTON BLVD #101
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City | LAS VEGAS
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State | NV
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Zip | 89117-1636
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Country | US
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Telephone | 702-396-0101
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Fax | 702-222-0212
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Authorized Official
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Title or Position | SPEECH THERAPIST/BEHAVIOR ANALYST
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Name | DR. CHRIS HOLCOMB
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Credential | PHD., CCC-SLP, BCBA
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Telephone | 702-292-2012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP620
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LBA0027
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License Number State | NV
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