Provider Demographics
NPI:1235295445
Name:THERAPY PLUS
Entity Type:Organization
Organization Name:THERAPY PLUS
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HARDEE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:706-868-0204
Mailing Address - Street 1:3207 MESENA LN
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-9658
Mailing Address - Country:US
Mailing Address - Phone:706-868-0204
Mailing Address - Fax:706-868-0208
Practice Address - Street 1:3207 MESENA LN
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-9658
Practice Address - Country:US
Practice Address - Phone:706-868-0204
Practice Address - Fax:706-868-0208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT000299225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA156458561AMedicaid
GA156458561AMedicaid
GA67BBBJWMedicare PIN