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Organization

CHOSEN ONE THERAPIES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DENIECE M PAYNE MS-SLP, MED (CLINICAL DIRECTOR)
(571) 330-8120
Entity
Organization

Contact information

Practice address
10851 TIDEWATER TRIAL, #103, FREDERICKSBURG, VA 22408-0260
(571) 330-8120
(877) 771-3419
Mailing address
17775 MAIN ST, STE 104, DUMFRIES, VA 22026-2491
(540) 693-6997
(877) 771-3419

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
171R00000X
Interpreter
174400000X
Specialist
Primary
2355S0801X
Speech-Language Assistant
235Z00000X
Speech-Language Pathologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1073788931
VA
05
1730494329
VA
01
C10948
GROUP PROVIDER (PTAN)
VA
Enumeration date
08/09/2010
Last updated
11/24/2014
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