Provider Demographics
NPI:1942735246
Name:THERAPY BUILDERS, LLC
Entity Type:Organization
Organization Name:THERAPY BUILDERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAHNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-980-4164
Mailing Address - Street 1:26934 N 178TH AVE
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85387-1075
Mailing Address - Country:US
Mailing Address - Phone:623-980-4164
Mailing Address - Fax:
Practice Address - Street 1:26934 N 178TH AVE
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85387-1075
Practice Address - Country:US
Practice Address - Phone:623-980-4164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty