Provider Demographics
NPI:1003411281
Name:ORANGE COUNTY THERAPY GROUP: SLP, PT, OT , PLLC
Entity Type:Organization
Organization Name:ORANGE COUNTY THERAPY GROUP: SLP, PT, OT , PLLC
Other - Org Name:ORANGE COUNTY SPEECH & SWALLOW, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:NUTT
Authorized Official - Suffix:III
Authorized Official - Credentials:MS CCC/SLP
Authorized Official - Phone:845-728-1623
Mailing Address - Street 1:35 TWIN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL HALL
Mailing Address - State:NY
Mailing Address - Zip Code:10916-2107
Mailing Address - Country:US
Mailing Address - Phone:845-728-1623
Mailing Address - Fax:
Practice Address - Street 1:35 TWIN OAKS DR
Practice Address - Street 2:
Practice Address - City:CAMPBELL HALL
Practice Address - State:NY
Practice Address - Zip Code:10916-2107
Practice Address - Country:US
Practice Address - Phone:845-728-1623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-03
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management