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General NPI Number Information
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NPI Number | 1588119507
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Entity Type | Organization
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Legal Business Name | THERAPY SERVICES
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Dates
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Enumeration Date | 08/19/2016
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Last Update Date | 08/19/2016
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Provider Practice Location Address
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Address Line | 1868 MCKELVEY HILL DR APT D
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City | MARYLAND HEIGHTS
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State | MO
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Zip | 63043-3926
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Country | US
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Telephone | 314-873-9723
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Fax |
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Provider Business Mailing Address
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Address Line | 1868 MCKELVEY HILL DR APT D
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City | MARYLAND HEIGHTS
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State | MO
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Zip | 63043-3926
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Country | US
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Telephone | 314-873-9723
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | CHUNDRA DANIELLE WILLIAMS
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Credential | LCSW
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Telephone | 314-873-9723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 2016016569
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2016016569
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License Number State | MO
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