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General NPI Number Information
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NPI Number | 1487603064
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Entity Type | Organization
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Legal Business Name | CYPRESS CREEK THERAPY ASSOCIATES LLC
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 05/14/2008
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Provider Practice Location Address
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Address Line | 645 BALTIMORE ANNAPOLIS BLVD SUITE 111
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City | SEVERNA PARK
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State | MD
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Zip | 21146-3931
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Country | US
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Telephone | 410-384-9129
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Fax | 410-384-9725
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Provider Business Mailing Address
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Address Line | 645 BALTIMORE ANNAPOLIS BLVD SUITE 111
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City | SEVERNA PARK
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State | MD
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Zip | 21146-3931
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Country | US
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Telephone | 410-384-9129
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Fax | 410-384-9725
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LEWIS A POWERS
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Credential | P.T.
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Telephone | 410-384-9129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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 #3
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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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