Provider Demographics
NPI:1578819306
Name:INTEGRATED THERAPY SERVICES
Entity type:Organization
Organization Name:INTEGRATED THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:CCSLP
Authorized Official - Phone:301-933-7880
Mailing Address - Street 1:10605 CONCORD ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2504
Mailing Address - Country:US
Mailing Address - Phone:301-933-7880
Mailing Address - Fax:
Practice Address - Street 1:10605 CONCORD ST
Practice Address - Street 2:SUITE 102
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2504
Practice Address - Country:US
Practice Address - Phone:301-933-7880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01497261QA3000X, 261QD1600X, 261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QA3000XAmbulatory Health Care FacilitiesClinic/CenterAugmentative Communication
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities