Provider Demographics
NPI:1881834182
Name:NORTH COAST OCCUPATIONAL, PHYSICAL & SPEECH THERAPY PLLC
Entity Type:Organization
Organization Name:NORTH COAST OCCUPATIONAL, PHYSICAL & SPEECH THERAPY PLLC
Other - Org Name:NORTH COAST THERAPY LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:315-388-7703
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:10 MAIN STREET
Mailing Address - City:WADDINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:13694-0249
Mailing Address - Country:US
Mailing Address - Phone:315-388-7703
Mailing Address - Fax:315-388-4707
Practice Address - Street 1:10 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WADDINGTON
Practice Address - State:NY
Practice Address - Zip Code:13694-0249
Practice Address - Country:US
Practice Address - Phone:315-388-7703
Practice Address - Fax:315-388-4707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-26
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency