Provider Demographics
NPI:1154669935
Name:LEMON TREE PEDIATRIC THERAPY SERVICES, INC
Entity Type:Organization
Organization Name:LEMON TREE PEDIATRIC THERAPY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LEMON
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L
Authorized Official - Phone:708-351-5429
Mailing Address - Street 1:7753 VANBUREN ST #317
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60130
Mailing Address - Country:US
Mailing Address - Phone:708-351-5429
Mailing Address - Fax:855-529-1595
Practice Address - Street 1:7753 VANBUREN ST
Practice Address - Street 2:UNIT 317
Practice Address - City:FOREST PARK
Practice Address - State:IL
Practice Address - Zip Code:60130-4802
Practice Address - Country:US
Practice Address - Phone:708-351-5429
Practice Address - Fax:855-529-1595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056007887252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency