Organization
SPECTRUM THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA DEVIVIO MS IN ED, PD IN ED (SUPERINTENDENT)
(631) 385-3342
Entity
Organization
Contact information
Practice address
21 SWEET HOLLOW RD, HUNTINGTON, NY 11743-6530
(631) 385-3342
Mailing address
21 SWEET HOLLOW RD, HUNTINGTON, NY 11743-6530
(631) 385-3342
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261Q00000X
Clinic/Center
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
03/12/2018
Last updated
03/12/2018
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