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General NPI Number Information
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NPI Number | 1982620183
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC INTERVENTIONS OF GEORGIA,INC
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2315 CENTRAL AVE STE C
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City | AUGUSTA
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State | GA
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Zip | 30904-6246
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Country | US
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Telephone | 706-364-6172
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Fax |
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Provider Business Mailing Address
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Address Line | 2315 CENTRAL AVE STE C
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City | AUGUSTA
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State | GA
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Zip | 30904-6246
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Country | US
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Telephone | 706-364-6172
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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 | JENNIFER STEPHENS
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Credential | PHD-CCC-SLP
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Telephone | 706-364-6172
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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 | 025171
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 025171
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 025171
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License Number State | GA
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