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General NPI Number Information
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NPI Number | 1669294195
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Entity Type | Organization
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Legal Business Name | AFFINITY THERAPY LLC
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 01/05/2025
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Provider Practice Location Address
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Address Line | 705 S BROADWAY ST # 1011
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City | PORTLAND
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State | TN
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Zip | 37148-1628
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Country | US
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Telephone | 615-953-0390
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Fax |
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Provider Business Mailing Address
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Address Line | 2443 HIGHWAY 41 S UNIT 104
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City | GREENBRIER
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State | TN
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Zip | 37073-4540
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SLP
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Name | MARINA COAKLEY
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Credential |
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Telephone | 615-953-0390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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