Provider Demographics
NPI:1164769451
Name:PHOENIX THERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:PHOENIX THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:FINK
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:704-282-0818
Mailing Address - Street 1:PO BOX 3032
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28111-3032
Mailing Address - Country:US
Mailing Address - Phone:704-282-0818
Mailing Address - Fax:704-635-8353
Practice Address - Street 1:3213 STUMP LAKE DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-8798
Practice Address - Country:US
Practice Address - Phone:704-282-0818
Practice Address - Fax:704-635-8353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty