Provider Demographics
NPI:1942591821
Name:THERAPY HUT, INC.
Entity Type:Organization
Organization Name:THERAPY HUT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MARWYN
Authorized Official - Middle Name:GARIBAY
Authorized Official - Last Name:BENEMERITO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:901-309-5219
Mailing Address - Street 1:895 WILLOW TREE CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-3107
Mailing Address - Country:US
Mailing Address - Phone:901-309-5219
Mailing Address - Fax:901-309-5265
Practice Address - Street 1:895 WILLOW TREE CIR STE 100
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-3107
Practice Address - Country:US
Practice Address - Phone:901-309-5219
Practice Address - Fax:901-309-5265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3892225X00000X
TN955225X00000X
TN2379235Z00000X
TN3275235Z00000X
TN3278235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4285501OtherBCBS
TN7813841OtherAETNA