Organization Name: | DIVERSE THERAPY INC |
NPI Number: | 1700285178 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHELLE A TOMLINSON (OCCUPATIONAL THERAPIST) |
Mailing Address: | 6740 James B Rivers Dr Stone Mountain |
State: | GA US |
Postal Code: | 300832235 |
Phone Number: | 6782503250 |
Fax Number: | 4703758754 |
NPI Enumeration Date: | 08/21/2014 |
NPI Last Update Date: | 08/21/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |