Provider Demographics
NPI:1992575948
Name:MAGNOLIA THERAPY SOLUTIONS
Entity type:Organization
Organization Name:MAGNOLIA THERAPY SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:SLP, BCBA
Authorized Official - Phone:504-250-6422
Mailing Address - Street 1:1391 W 5TH AVE # 401
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2902
Mailing Address - Country:US
Mailing Address - Phone:504-250-6422
Mailing Address - Fax:
Practice Address - Street 1:1391 W 5TH AVE # 401
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2902
Practice Address - Country:US
Practice Address - Phone:504-250-6422
Practice Address - Fax:504-354-8078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty