# MLPHENRYDBA DEVELOPMENTAL THERAPY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457788929
- **Authorized official:** MRS. MARGARET LISA PIKE HENRY (CBRS PROVIDER)
- **Authorized official phone:** (336) 214-2879

## Contact information

- **Practice address:** 7125 BASS MOUNTAIN RD, SNOW CAMP, NC 27349-9167
- **Practice address phone:** (336) 214-2879
- **Mailing address:** 7125 BASS MOUNTAIN RD, SNOW CAMP, NC 27349-9167

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251X00000X | Supports Brokerage Agency | CBRS INFANT TODDLER | NC | Yes |

## Other

- **Enumeration date:** 09/30/2013
- **Last updated:** 10/16/2013