Provider Demographics
NPI:1598154544
Name:THERAPY CORNER,LLC
Entity Type:Organization
Organization Name:THERAPY CORNER,LLC
Other - Org Name:THERAPY CORNER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OTR
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:P
Authorized Official - Last Name:COLUNGA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:956-454-3051
Mailing Address - Street 1:2001 W 3 MILE LINE
Mailing Address - Street 2:2400
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573-4287
Mailing Address - Country:US
Mailing Address - Phone:956-454-3051
Mailing Address - Fax:
Practice Address - Street 1:2001 W MILE 3 RD
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78573-4287
Practice Address - Country:US
Practice Address - Phone:956-454-3051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112252225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty