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Organization

INNOVATIVE THERAPY LLC

Active
Other names
Innovative Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
LINDSEY GRACE GLEASON M.S.CCC-SLP (OWNER/MANAGING PARTNER)
(757) 450-0977
Entity
Organization

Contact information

Practice address
900 COMMONWEALTH PLACE, SUITE 365, VIRGINIA BEACH, VA 23464
(757) 373-2023
(757) 447-0139
Mailing address
900 COMMONWEALTH PLACE, SUITE 365, VIRGINIA BEACH, VA 23464
(757) 373-2023
(757) 447-0139

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
225X00000X
Occupational Therapist
225XP0200X
Pediatric Occupational Therapist
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
11/23/2020
Last updated
07/09/2021
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