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General NPI Number Information
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NPI Number | 1386951812
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Entity Type | Organization
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Legal Business Name | A PLUS EXTENDED THERAPY INC
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Dates
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Enumeration Date | 09/03/2010
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Last Update Date | 09/03/2010
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Provider Practice Location Address
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Address Line | 1920 S HIGHLAND AVE STE 314
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City | LOMBARD
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State | IL
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Zip | 60148-4988
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Country | US
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Telephone | 708-704-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 1920 S HIGHLAND AVE STE 314
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City | LOMBARD
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State | IL
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Zip | 60148-4988
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Country | US
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Telephone | 708-704-0000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DURGA TADIPARTHY
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Credential |
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Telephone | 562-809-8958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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