Provider Demographics
NPI:1184635112
Name:THERAPY DYNAMICS
Entity Type:Organization
Organization Name:THERAPY DYNAMICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCALLA-WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-788-7722
Mailing Address - Street 1:1710 W FAIRBANKS AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4612
Mailing Address - Country:US
Mailing Address - Phone:407-788-7722
Mailing Address - Fax:407-788-7723
Practice Address - Street 1:1710 W FAIRBANKS AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4612
Practice Address - Country:US
Practice Address - Phone:407-788-7722
Practice Address - Fax:407-788-7723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty