Provider Demographics
NPI:1265851380
Name:TOTS TO TEENS COMMUNICATION THERAPY, LLC
Entity Type:Organization
Organization Name:TOTS TO TEENS COMMUNICATION THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:THERIOT
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:601-889-9800
Mailing Address - Street 1:117 B N. MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:PICAYUNE
Mailing Address - State:MS
Mailing Address - Zip Code:39466
Mailing Address - Country:US
Mailing Address - Phone:601-889-9800
Mailing Address - Fax:601-889-9885
Practice Address - Street 1:117B N MAIN ST
Practice Address - Street 2:
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-3928
Practice Address - Country:US
Practice Address - Phone:601-889-9800
Practice Address - Fax:601-889-9885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty