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Organization

THERAPYLAND LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
THANE BROOKS (PRESIDENT)
(678) 648-7644
Entity
Organization

Contact information

Practice address
6505 SHILOH RD, SUITE 100, ALPHARETTA, GA 30005-8405
(678) 648-7644
(678) 648-7479
Mailing address
6505 SHILOH RD, SUITE 100, ALPHARETTA, GA 30005-8405
(678) 648-7644
(678) 648-7479

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1062816
GA
2251P0200X
Pediatric Physical Therapist
225XP0200X
Pediatric Occupational Therapist
235Z00000X
Speech-Language Pathologist

Other

Enumeration date
06/25/2014
Last updated
03/11/2015
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