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General NPI Number Information
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NPI Number | 1326385444
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Entity Type | Organization
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Legal Business Name | THE THERAPY CENTER OF HENDERSONVILLE
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Dates
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Enumeration Date | 01/09/2013
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Last Update Date | 01/09/2013
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Provider Practice Location Address
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Address Line | 139 MAPLE ROW BLVD SUITE 202
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-4487
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Country | US
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Telephone | 615-826-7113
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Fax | 615-826-7139
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Provider Business Mailing Address
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Address Line | 139 MAPLE ROW BLVD SUITE 202
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-4487
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Country | US
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Telephone | 615-826-7113
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Fax | 615-826-7139
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KELLEY BRANTLEY SOUTHARD
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Credential | P.T.
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Telephone | 615-826-7113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical 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 | 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 #3
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric 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 | 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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Taxonomy #5
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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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