Provider Demographics
NPI:1144424185
Name:THERAPY KINECTIONS, LLC
Entity Type:Organization
Organization Name:THERAPY KINECTIONS, LLC
Other - Org Name:THERAPY KINECTIONS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:203-262-9909
Mailing Address - Street 1:1 RESERVOIR OFFICE PARK STE 104
Mailing Address - Street 2:1449 OLD WATERBURY ROAD
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-3926
Mailing Address - Country:US
Mailing Address - Phone:203-262-9909
Mailing Address - Fax:203-262-9911
Practice Address - Street 1:1 RESERVOIR OFFICE PARK STE 104
Practice Address - Street 2:1449 OLD WATERBURY ROAD
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-3926
Practice Address - Country:US
Practice Address - Phone:203-262-9909
Practice Address - Fax:203-262-9911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0001593174400000X
CT001953225X00000X
CT1472235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty