Provider Demographics
| NPI: | 1841516366 |
|---|---|
| Name: | INTEGRATED THERAPY ALLIANCE, INC |
| Entity type: | Organization |
| Organization Name: | INTEGRATED THERAPY ALLIANCE, INC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | SPEECH-LANGUAGE PATHOLOGIST |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | NATALIE |
| Authorized Official - Middle Name: | PUGH |
| Authorized Official - Last Name: | SOUEIDAN |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MS, CCC-SLP |
| Authorized Official - Phone: | 813-973-9068 |
| Mailing Address - Street 1: | 5807 ARGERIAN DR STE 101 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WESLEY CHAPEL |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 33545-4151 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 813-973-9068 |
| Mailing Address - Fax: | 866-542-4710 |
| Practice Address - Street 1: | 5807 ARGERIAN DR STE 101 |
| Practice Address - Street 2: | |
| Practice Address - City: | WESLEY CHAPEL |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 33545-4151 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 813-973-9068 |
| Practice Address - Fax: | 866-542-4710 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2010-04-08 |
| Last Update Date: | 2014-12-23 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
| No | 222Q00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist | Group - Multi-Specialty | |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 2355S0801X | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant | Group - Multi-Specialty |
| No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
| No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
| No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
| No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
| No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
| No | 225XF0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Feeding, Eating & Swallowing | Group - Multi-Specialty |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty |
