Provider Demographics
NPI:1033991146
Name:KIDVANCEMENT LLC
Entity Type:Organization
Organization Name:KIDVANCEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEAGAN
Authorized Official - Middle Name:WISNIEWSKI
Authorized Official - Last Name:PASQUINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-331-6446
Mailing Address - Street 1:2500 FONDREN RD STE 205
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2313
Mailing Address - Country:US
Mailing Address - Phone:713-331-6446
Mailing Address - Fax:
Practice Address - Street 1:2500 FONDREN RD STE 205
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2313
Practice Address - Country:US
Practice Address - Phone:713-331-6446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty