Organization
BLUE MOUNTAIN THERAPY, LLC
Active
Organization
BLUE MOUNTAIN THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH CLINT WADDELL (ADMINISTRATION)
(276) 525-6043
Entity
Organization
Contact information
Practice address
17507 LEE HWY, ABINGDON, VA 24210-7835
(276) 525-6043
(888) 233-7885
Mailing address
17507 LEE HWY, ABINGDON, VA 24210-7835
(276) 525-6043
(888) 233-7885
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760818595
—
VA
Enumeration date
09/25/2013
Last updated
06/16/2022
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