Provider Demographics
NPI:1225477961
Name:SLM THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:SLM THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L
Authorized Official - Phone:719-648-3764
Mailing Address - Street 1:421 S TEJON ST
Mailing Address - Street 2:SUITE 311
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-2131
Mailing Address - Country:US
Mailing Address - Phone:719-648-3764
Mailing Address - Fax:719-886-7113
Practice Address - Street 1:421 S TEJON ST
Practice Address - Street 2:SUITE 311
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2131
Practice Address - Country:US
Practice Address - Phone:719-648-3764
Practice Address - Fax:719-886-7113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-16
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1686261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation