Provider Demographics
NPI:1073368775
Name:DIVERGENT THERAPY SERVICES LLC
Entity type:Organization
Organization Name:DIVERGENT THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:
Authorized Official - Last Name:HEDGEPATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-283-1891
Mailing Address - Street 1:101 CAHABA FOREST DR
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-2083
Mailing Address - Country:US
Mailing Address - Phone:256-283-1891
Mailing Address - Fax:
Practice Address - Street 1:1976 GADSDEN HWY STE 208
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3266
Practice Address - Country:US
Practice Address - Phone:256-283-1891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-17
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty