Provider Demographics
NPI:1912404070
Name:THERAPEUTIC EMPLOYEE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:THERAPEUTIC EMPLOYEE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEITRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FANT
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:318-791-0022
Mailing Address - Street 1:6192 TROTTERS GLEN DR
Mailing Address - Street 2:
Mailing Address - City:HUGHESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20637-2876
Mailing Address - Country:US
Mailing Address - Phone:318-791-0022
Mailing Address - Fax:
Practice Address - Street 1:6192 TROTTERS GLEN DR
Practice Address - Street 2:
Practice Address - City:HUGHESVILLE
Practice Address - State:MD
Practice Address - Zip Code:20637-2876
Practice Address - Country:US
Practice Address - Phone:318-791-0022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-06
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty