| Developmental Therapy Outreach Services | |
|
4506 Tyne Dr Durham NC 27703-2891 | |
| (919) 596-5047 | |
| Not Available |
| Full Name | Developmental Therapy Outreach Services |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4506 Tyne Dr, Durham, North Carolina |
| Authorized Official Name and Position | Sajina Cooper (BILLING) |
| Authorized Official Contact | 9193811112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Developmental Therapy Outreach Services Po Box 11928 Durham NC 27703-1928 Ph: () - | Developmental Therapy Outreach Services 4506 Tyne Dr Durham NC 27703-2891 Ph: (919) 596-5047 |
| NPI Number | 1225222896 |
|---|---|
| Provider Enumeration Date | 08/28/2007 |
| Last Update Date | 08/28/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225222896 | NPI | - | NPPES |
| 8302047K | Medicaid | NC | |
| 8302047 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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