Provider Demographics
NPI:1831881259
Name:THREE SPARROWS THERAPY, LLC
Entity type:Organization
Organization Name:THREE SPARROWS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:M ED, CCC-SLP
Authorized Official - Phone:706-302-0299
Mailing Address - Street 1:1696 OAK GROVE RD
Mailing Address - Street 2:
Mailing Address - City:PINE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:31822-4554
Mailing Address - Country:US
Mailing Address - Phone:706-302-0299
Mailing Address - Fax:888-902-2061
Practice Address - Street 1:204 W HARALSON ST
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240-2722
Practice Address - Country:US
Practice Address - Phone:706-302-0299
Practice Address - Fax:888-902-2061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-24
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty