Provider Demographics
NPI:1093026312
Name:THERAPEUTIC INTEGRATIONS LLC
Entity Type:Organization
Organization Name:THERAPEUTIC INTEGRATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:COLBY
Authorized Official - Middle Name:MARA
Authorized Official - Last Name:KEYSER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:267-775-3012
Mailing Address - Street 1:7250 HOLLYWOOD RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2016
Mailing Address - Country:US
Mailing Address - Phone:267-775-3012
Mailing Address - Fax:267-775-3012
Practice Address - Street 1:7250 HOLLYWOOD RD
Practice Address - Street 2:SUITE 4
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-2016
Practice Address - Country:US
Practice Address - Phone:267-775-3012
Practice Address - Fax:267-775-3012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC009270225XP0200X
NJ46TR00411800225XP0200X
PASL005469L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty