Provider Demographics
NPI:1841762523
Name:TRAUMA DRAMA THERAPY, LLC
Entity Type:Organization
Organization Name:TRAUMA DRAMA THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:RUMPEL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CPCS
Authorized Official - Phone:912-660-6957
Mailing Address - Street 1:119 DYCHES DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-5705
Mailing Address - Country:US
Mailing Address - Phone:912-660-6957
Mailing Address - Fax:
Practice Address - Street 1:119 DYCHES DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-5705
Practice Address - Country:US
Practice Address - Phone:912-660-6957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty