Provider Demographics
NPI:1467663740
Name:THE THERAPY SOURCE, INC
Entity type:Organization
Organization Name:THE THERAPY SOURCE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CRIPPEN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:303-345-8688
Mailing Address - Street 1:5409 S GARRISON ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-7403
Mailing Address - Country:US
Mailing Address - Phone:303-345-8688
Mailing Address - Fax:
Practice Address - Street 1:5409 S GARRISON ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-7403
Practice Address - Country:US
Practice Address - Phone:303-345-8688
Practice Address - Fax:303-932-1275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO31403875Medicaid