Provider Demographics
NPI:1275143356
Name:EARL THERAPY PLLC
Entity Type:Organization
Organization Name:EARL THERAPY PLLC
Other - Org Name:STARLINE THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:EARL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT
Authorized Official - Phone:224-707-1098
Mailing Address - Street 1:289 MOUNT LANGLEY ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-7674
Mailing Address - Country:US
Mailing Address - Phone:224-707-1098
Mailing Address - Fax:
Practice Address - Street 1:289 MOUNT LANGLEY ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7674
Practice Address - Country:US
Practice Address - Phone:224-707-1098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-04
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty