Provider Demographics
NPI:1336471622
Name:LOCAL THERAPY, LLC
Entity Type:Organization
Organization Name:LOCAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, SLP/CCC
Authorized Official - Phone:307-326-8111
Mailing Address - Street 1:1210 RIVER STREET
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:WY
Mailing Address - Zip Code:82331-1452
Mailing Address - Country:US
Mailing Address - Phone:307-326-8111
Mailing Address - Fax:307-326-8111
Practice Address - Street 1:1210 SO RIVER ST
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:WY
Practice Address - Zip Code:82331-1452
Practice Address - Country:US
Practice Address - Phone:307-326-8111
Practice Address - Fax:307-326-8111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY33235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty