Provider Demographics
NPI:1639496151
Name:APPLE THERAPY CENTER CORP
Entity Type:Organization
Organization Name:APPLE THERAPY CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ISORA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MSCCC-SLP
Authorized Official - Phone:407-744-4475
Mailing Address - Street 1:2244 BOGGY CREEK RD STE F
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-6111
Mailing Address - Country:US
Mailing Address - Phone:407-574-5109
Mailing Address - Fax:407-574-6546
Practice Address - Street 1:2244 BOGGY CREEK RD STE F
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-6111
Practice Address - Country:US
Practice Address - Phone:407-574-5109
Practice Address - Fax:407-574-6546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8538235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty