Provider Demographics
NPI:1891496154
Name:FANNING THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:FANNING THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CCC-SLP
Authorized Official - Prefix:
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:FANNING
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:571-495-9905
Mailing Address - Street 1:815 WOODCREST LOOP
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-3175
Mailing Address - Country:US
Mailing Address - Phone:571-495-9905
Mailing Address - Fax:
Practice Address - Street 1:815 WOODCREST LOOP
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3175
Practice Address - Country:US
Practice Address - Phone:571-495-9905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty