Provider Demographics
NPI:1225419039
Name:KIDS ONLINE THERAPY WORKS LLC
Entity Type:Organization
Organization Name:KIDS ONLINE THERAPY WORKS LLC
Other - Org Name:KIDS THERAPY WORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MACCC, SLP
Authorized Official - Phone:703-932-2099
Mailing Address - Street 1:2824 SYRACUSE CT
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2454
Mailing Address - Country:US
Mailing Address - Phone:703-932-2099
Mailing Address - Fax:303-474-3011
Practice Address - Street 1:2824 SYRACUSE CT
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-2454
Practice Address - Country:US
Practice Address - Phone:703-932-2099
Practice Address - Fax:303-474-3011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP0001743235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty