Provider Demographics
NPI:1447982442
Name:ADM THERAPY CLINIS
Entity type:Organization
Organization Name:ADM THERAPY CLINIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDOVAL COLON
Authorized Official - Suffix:
Authorized Official - Credentials:SLA
Authorized Official - Phone:939-250-4285
Mailing Address - Street 1:560 CALLE FLAMENCO
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-9453
Mailing Address - Country:US
Mailing Address - Phone:939-250-4285
Mailing Address - Fax:
Practice Address - Street 1:13 CALLE LUIS MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-2424
Practice Address - Country:US
Practice Address - Phone:939-250-4285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty