Provider Demographics
NPI:1205334133
Name:THERAPY RESOURCES,SPEECH AND LANGUAGE PATHOLOGY, PHYSICAL THERAPY & OC
Entity type:Organization
Organization Name:THERAPY RESOURCES,SPEECH AND LANGUAGE PATHOLOGY, PHYSICAL THERAPY & OC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:NADINE
Authorized Official - Last Name:WOOLSEY-LASKY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:716-972-0356
Mailing Address - Street 1:6445 W QUAKER ST
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-2354
Mailing Address - Country:US
Mailing Address - Phone:716-972-0356
Mailing Address - Fax:
Practice Address - Street 1:6445 W QUAKER ST
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-2354
Practice Address - Country:US
Practice Address - Phone:716-972-0356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-25
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
224Z00000X, 252Y00000X
NY224Z00000X, 225100000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty