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Organization
PHOENIX PEDIATRIC THERAPY SERVICES, LLC
Active
Organization
PHOENIX PEDIATRIC THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIFFANY B. PHOENIX M.S.,CCC-SLP (CEO/SPEECH-LANGUAGE PATHOLOGIST)
(240) 425-8605
Entity
Organization
Contact information
Practice address
16201 TRADE ZONE AVE STE 106, UPPER MARLBORO, MD 20774-8758
(240) 425-8605
Mailing address
12806 SHOLTON ST, UPPER MARLBORO, MD 20774-1715
(240) 620-5688
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/29/2020
Last updated
09/29/2020
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