Provider Demographics
NPI:1083887004
Name:PLAY AND EDUCATION FOR THE DEVELOPMENT OF INFANTS
Entity Type:Organization
Organization Name:PLAY AND EDUCATION FOR THE DEVELOPMENT OF INFANTS
Other - Org Name:PEDI CENTER FOR THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:JANESE HORN
Authorized Official - Last Name:PINSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:602-476-7519
Mailing Address - Street 1:15414 N 7TH ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-3519
Mailing Address - Country:US
Mailing Address - Phone:602-476-7519
Mailing Address - Fax:
Practice Address - Street 1:15414 N 7TH ST
Practice Address - Street 2:SUITE 3
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-3519
Practice Address - Country:US
Practice Address - Phone:602-476-7519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP4319261QH0700X
AZ5947261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech