Provider Demographics
NPI:1154687655
Name:WEEHABILITATE-PEDIATRIC THERAPY
Entity Type:Organization
Organization Name:WEEHABILITATE-PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:LEIGHAN
Authorized Official - Last Name:PARTEN
Authorized Official - Suffix:
Authorized Official - Credentials:MOT, OTR/L
Authorized Official - Phone:919-880-5770
Mailing Address - Street 1:2200 E MILLBROOK RD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-1788
Mailing Address - Country:US
Mailing Address - Phone:919-880-5770
Mailing Address - Fax:919-882-8605
Practice Address - Street 1:2200 E MILLBROOK RD
Practice Address - Street 2:SUITE 117
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1788
Practice Address - Country:US
Practice Address - Phone:919-880-5770
Practice Address - Fax:919-882-8605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty