Provider Demographics
NPI:1114164431
Name:TLC KID'S THERAPY
Entity Type:Organization
Organization Name:TLC KID'S THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBBIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:210-490-3900
Mailing Address - Street 1:835 ISOM RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4035
Mailing Address - Country:US
Mailing Address - Phone:210-490-3900
Mailing Address - Fax:
Practice Address - Street 1:835 ISOM RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4035
Practice Address - Country:US
Practice Address - Phone:210-490-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101643225X00000X
TX108618225X00000X
TX110228225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty