Provider Demographics
NPI:1821407446
Name:ADY THERAPY SERVICES
Entity Type:Organization
Organization Name:ADY THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:YOUNKINS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA, MS ED
Authorized Official - Phone:757-651-2655
Mailing Address - Street 1:4532 NORMAN RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-4925
Mailing Address - Country:US
Mailing Address - Phone:757-651-2655
Mailing Address - Fax:757-606-3131
Practice Address - Street 1:4532 NORMAN RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-4925
Practice Address - Country:US
Practice Address - Phone:757-651-2655
Practice Address - Fax:757-606-3131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000296174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty