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Organization
INNOVATIVE THERAPY SERVICES
Active
Organization
INNOVATIVE THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TASHA MICHELLE WINNS M.S. CCC-SLP (SPEECH PATHOLOGIST)
(301) 646-0304
Entity
Organization
Contact information
Practice address
632 TAHOE CIR, STONE MOUNTAIN, GA 30083-4450
(301) 646-0304
Mailing address
632 TAHOE CIR, STONE MOUNTAIN, GA 30083-4450
(301) 646-0304
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
SLP007594
GA
Other
Enumeration date
03/13/2013
Last updated
03/13/2013
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