Provider Demographics
NPI:1407129430
Name:TICKTALK THERAPY LLC
Entity Type:Organization
Organization Name:TICKTALK THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:FEDYUSHKINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-966-0535
Mailing Address - Street 1:8778 S MARYLAND PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-6705
Mailing Address - Country:US
Mailing Address - Phone:800-966-0535
Mailing Address - Fax:800-966-1135
Practice Address - Street 1:8778 S MARYLAND PKWY STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123
Practice Address - Country:US
Practice Address - Phone:800-966-0535
Practice Address - Fax:800-966-1135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty