Provider Demographics
NPI:1518582642
Name:LILLY THERAPY SERVICES
Entity Type:Organization
Organization Name:LILLY THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LILLY
Authorized Official - Suffix:
Authorized Official - Credentials:MS/CCC-SLP
Authorized Official - Phone:304-667-3448
Mailing Address - Street 1:PO BOX 1212
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-4212
Mailing Address - Country:US
Mailing Address - Phone:304-667-3448
Mailing Address - Fax:
Practice Address - Street 1:289 MAPLE AVE E
Practice Address - Street 2:
Practice Address - City:ALDERSON
Practice Address - State:WV
Practice Address - Zip Code:24910-9469
Practice Address - Country:US
Practice Address - Phone:304-667-3448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech