Organization
CAPTIAL THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAITLIN JENSEN MA (SPEECH LANGUAGE PATHOLOGIST)
(614) 570-1143
Entity
Organization
Contact information
Practice address
1923 INDEPENDENCE BLVD APT A, LANCASTER, OH 43130-1272
(740) 412-7923
Mailing address
1923 INDEPENDENCE BLVD APT A, LANCASTER, OH 43130-1272
(740) 412-7923
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
OH3205097
OH
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
OH3205097
OH
Other
Enumeration date
09/22/2014
Last updated
09/29/2014
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