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General NPI Number Information
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NPI Number | 1568276541
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Entity Type | Organization
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Legal Business Name | THE THERAPY LOFT, LLC
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Dates
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Enumeration Date | 02/01/2025
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Last Update Date | 02/01/2025
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Provider Practice Location Address
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Address Line | 925 GLENHAVEN DR
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City | EVANS
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State | GA
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Zip | 30809-0418
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Country | US
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Telephone | 706-267-0956
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Fax |
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Provider Business Mailing Address
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Address Line | 4451 WASHINGTON RD STE 90
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City | EVANS
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State | GA
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Zip | 30809-6326
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Country | US
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Telephone | 706-250-0458
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. LATONYA ADAMS
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Credential | LPC, NCC
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Telephone | 706-250-0428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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