Provider Demographics
NPI:1417632563
Name:FRIENDLY THERAPY LLC
Entity Type:Organization
Organization Name:FRIENDLY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LAURENCE
Authorized Official - Last Name:CHERUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:862-888-2806
Mailing Address - Street 1:3024 HIDDEN FOREST CT UNIT 6314
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-3160
Mailing Address - Country:US
Mailing Address - Phone:862-888-2806
Mailing Address - Fax:
Practice Address - Street 1:3024 HIDDEN FOREST CT UNIT 6314
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-3160
Practice Address - Country:US
Practice Address - Phone:862-888-2806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty