Organization
SPEECH & OCCUPATIONAL THERAPY SPECIALISTS
Active
Organization
SPEECH & OCCUPATIONAL THERAPY SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMIE TEAGUE BOONE MA/CCC-SLP (CLINICAL DIRECTOR)
(434) 228-1812
Entity
Organization
Contact information
Practice address
159 EXECUTIVE DR STE A, DANVILLE, VA 24541-4160
(434) 799-7732
(866) 468-5040
Mailing address
PO BOX 10864, DANVILLE, VA 24543-5015
(434) 799-7732
(866) 468-5040
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/29/2020
Last updated
05/02/2021
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