Organization
THERAPY CONSORTIUM INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA LARY CCCP-SLP (PRESIDENT)
(843) 455-7505
Entity
Organization
Contact information
Practice address
4761 HIGHWAY 501, SUITE #1, MYRTLE BEACH, SC 29579-9457
(843) 455-7505
Mailing address
PO BOX 1523, LITTLE RIVER, SC 29566-1523
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3377
—
SC
Enumeration date
06/03/2008
Last updated
03/10/2014
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