Provider Demographics
NPI:1992493795
Name:TINY TOES THERAPY, LLC
Entity type:Organization
Organization Name:TINY TOES THERAPY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:CAFFREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-560-2018
Mailing Address - Street 1:21630 RIDGETOP CIR
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-6564
Mailing Address - Country:US
Mailing Address - Phone:571-449-6281
Mailing Address - Fax:
Practice Address - Street 1:21630 RIDGETOP CIR
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-6564
Practice Address - Country:US
Practice Address - Phone:571-449-6281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty