Provider Demographics
NPI:1053132357
Name:EVOLVE THERAPY SOLUTIONS LLC
Entity type:Organization
Organization Name:EVOLVE THERAPY SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:ROSE LOVETT
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:
Authorized Official - Credentials:MED, CCC-SLP
Authorized Official - Phone:229-560-6600
Mailing Address - Street 1:53 LOGANBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2303
Mailing Address - Country:US
Mailing Address - Phone:229-560-6600
Mailing Address - Fax:229-231-2980
Practice Address - Street 1:53 LOGANBERRY CIR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2303
Practice Address - Country:US
Practice Address - Phone:229-560-6600
Practice Address - Fax:229-231-2980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty