Provider Demographics
NPI:1669854105
Name:TALK TIME THERAPEUTIC INTERVENTIONS, LLC
Entity Type:Organization
Organization Name:TALK TIME THERAPEUTIC INTERVENTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:GRAYSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:601-850-8380
Mailing Address - Street 1:6316 LYNDON B JOHNSON DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39213-2921
Mailing Address - Country:US
Mailing Address - Phone:601-850-8380
Mailing Address - Fax:601-366-9067
Practice Address - Street 1:6316 LYNDON B JOHNSON DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39213-2921
Practice Address - Country:US
Practice Address - Phone:601-850-8380
Practice Address - Fax:601-366-9067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-21
Last Update Date:2015-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3703251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health