Organization
ESSENTIAL THERAPY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA BLACK MS. OT/L (OWNER)
(770) 378-5986
Entity
Organization
Contact information
Practice address
4640 MARTIN RD, CUMMING, GA 30041-5533
(678) 679-1261
(678) 250-9010
Mailing address
4640 MARTIN RD, CUMMING, GA 30041-5571
(678) 679-1261
(678) 250-9010
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
304370677A
—
GA
Enumeration date
05/25/2007
Last updated
10/13/2025
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