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General NPI Number Information
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NPI Number | 1730494329
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Entity Type | Organization
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Legal Business Name | CHOSEN ONE THERAPIES, INC
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Dates
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Enumeration Date | 08/09/2010
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Last Update Date | 11/24/2014
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Provider Practice Location Address
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Address Line | 10851 TIDEWATER TRIAL #103
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City | FREDERICKSBURG
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State | VA
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Zip | 22408-0260
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Country | US
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Telephone | 571-330-8120
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Fax | 877-771-3419
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Provider Business Mailing Address
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Address Line | 17775 MAIN ST STE 104
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City | DUMFRIES
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State | VA
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Zip | 22026-2491
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Country | US
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Telephone | 540-693-6997
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Fax | 877-771-3419
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MS. DENIECE M PAYNE
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Credential | MS-SLP, MED
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Telephone | 571-330-8120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 171R00000X
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Taxonomy Name | Interpreter
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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Taxonomy #4
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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 #5
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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