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General NPI Number Information
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NPI Number | 1518680206
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Entity Type | Organization
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Legal Business Name | INCLUSIVE THERAPY SERVICES LLC
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 922 HICKORY DR
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City | VINE GROVE
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State | KY
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Zip | 40175-1020
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Country | US
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Telephone | 270-317-3801
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Fax |
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Provider Business Mailing Address
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Address Line | 922 HICKORY DR
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City | VINE GROVE
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State | KY
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Zip | 40175-1020
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Country | US
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Telephone | 270-317-3801
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Fax |
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Authorized Official
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Title or Position | OWNER/SPEECH LANGUAGE PATHOLOGIST
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Name | HOLLY S. SHEROAN
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Credential | M.S. CCC-SLP
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Telephone | 270-317-3801
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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 |
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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 | 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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