Provider Demographics
NPI:1235463357
Name:BEST LIFE THERAPY
Entity Type:Organization
Organization Name:BEST LIFE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH - LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JEANNINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:MS-CCC/SLP
Authorized Official - Phone:304-622-2029
Mailing Address - Street 1:RR 1 BOX 299-91
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLARE
Mailing Address - State:WV
Mailing Address - Zip Code:26408-9701
Mailing Address - Country:US
Mailing Address - Phone:304-622-2029
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 299-91
Practice Address - Street 2:
Practice Address - City:MOUNT CLARE
Practice Address - State:WV
Practice Address - Zip Code:26408-9701
Practice Address - Country:US
Practice Address - Phone:304-622-2029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty