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General NPI Number Information
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NPI Number | 1407889850
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC INTERVENTION SERVICES FOR CHILDREN, INC.
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 05/01/2009
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Provider Practice Location Address
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Address Line | 1802 CARMEL RD
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City | GREENSBORO
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State | NC
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Zip | 27408-3120
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Country | US
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Telephone | 336-282-6222
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Fax | 336-282-5723
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Provider Business Mailing Address
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Address Line | 1802 CARMEL RD
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City | GREENSBORO
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State | NC
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Zip | 27408-3120
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Country | US
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Telephone | 336-282-6222
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Fax | 336-282-5723
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. RUTH JEANNETTE YOUNG
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Credential | P.T.
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Telephone | 336-282-6222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 9058
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License Number State | NC
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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 | 6001
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License Number State | NC
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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 | 5161
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1686
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License Number State | NC
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