Provider Demographics
NPI:1639481104
Name:INTEGRATIVE THERAPY PARTNERS
Entity Type:Organization
Organization Name:INTEGRATIVE THERAPY PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC- A/SLP
Authorized Official - Phone:513-544-5991
Mailing Address - Street 1:5270 ALPINE CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-5951
Mailing Address - Country:US
Mailing Address - Phone:513-544-5991
Mailing Address - Fax:513-342-1688
Practice Address - Street 1:5270 ALPINE CT
Practice Address - Street 2:
Practice Address - City:LIBERTY TWP
Practice Address - State:OH
Practice Address - Zip Code:45011-5951
Practice Address - Country:US
Practice Address - Phone:513-544-5991
Practice Address - Fax:513-342-1688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3287235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty