Provider Demographics
NPI:1609588037
Name:DYNAMIC THERAPIES LLC
Entity Type:Organization
Organization Name:DYNAMIC THERAPIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-605-7134
Mailing Address - Street 1:14 GLEN HOLLOW DR APT E43
Mailing Address - Street 2:
Mailing Address - City:HOLTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11742-2441
Mailing Address - Country:US
Mailing Address - Phone:516-605-7134
Mailing Address - Fax:
Practice Address - Street 1:14 GLEN HOLLOW DR APT E43
Practice Address - Street 2:
Practice Address - City:HOLTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11742-2441
Practice Address - Country:US
Practice Address - Phone:516-605-7134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech