Provider Demographics
NPI:1386328409
Name:DG THERAPY GROUP INC.
Entity type:Organization
Organization Name:DG THERAPY GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLPA
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:YETZKE
Authorized Official - Suffix:
Authorized Official - Credentials:SLPA
Authorized Official - Phone:626-774-1662
Mailing Address - Street 1:12411 SLAUSON AVE STE G
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-2835
Mailing Address - Country:US
Mailing Address - Phone:562-693-5449
Mailing Address - Fax:
Practice Address - Street 1:12411 SLAUSON AVE STE G
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2835
Practice Address - Country:US
Practice Address - Phone:562-693-5449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center