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General NPI Number Information
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NPI Number | 1285025767
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Entity Type | Organization
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Legal Business Name | WHOLE CHILD THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 02/05/2015
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 344 CLEVELAND AVE SE STE F
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City | TUMWATER
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State | WA
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Zip | 98501-3342
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Country | US
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Telephone | 603-350-2220
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Fax |
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Provider Business Mailing Address
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Address Line | 344 CLEVELAND AVE SE STE F
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City | TUMWATER
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State | WA
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Zip | 98501-3342
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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 | SPEECH-LANGUAGE PATHOLOGIST
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Name | MRS. MARY KATHRYN COBURN
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Credential | CCC-SLP
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Telephone | 575-442-3405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental 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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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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 #4
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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Taxonomy #5
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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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