Provider Demographics
NPI:1942611496
Name:DYNAMIC THERAPY SPECIALISTS, LLC
Entity Type:Organization
Organization Name:DYNAMIC THERAPY SPECIALISTS, LLC
Other - Org Name:DYNAMIC THERAPY SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:225-767-5032
Mailing Address - Street 1:9270 SIEGEN LN BLDG 501
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-0934
Mailing Address - Country:US
Mailing Address - Phone:225-767-5032
Mailing Address - Fax:888-531-1703
Practice Address - Street 1:9270 SIEGEN LN BLDG 501
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-0934
Practice Address - Country:US
Practice Address - Phone:225-767-5032
Practice Address - Fax:888-531-1703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-17
Last Update Date:2014-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty