Provider Demographics
NPI:1346430329
Name:AUGUSTA THERAPY SERVICES FOR CHILDREN
Entity Type:Organization
Organization Name:AUGUSTA THERAPY SERVICES FOR CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:D
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:I
Authorized Official - Credentials:MHE,OTR/L
Authorized Official - Phone:706-294-3773
Mailing Address - Street 1:PO BOX 12094
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30914-2094
Mailing Address - Country:US
Mailing Address - Phone:706-589-3773
Mailing Address - Fax:803-202-0334
Practice Address - Street 1:707 STANTON DR
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-3264
Practice Address - Country:US
Practice Address - Phone:706-294-3773
Practice Address - Fax:803-202-0334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2009-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty