Provider Demographics
NPI:1235554478
Name:JENNY LANDSBERG
Entity Type:Organization
Organization Name:JENNY LANDSBERG
Other - Org Name:PEDIATRIC THERAPY SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-487-0947
Mailing Address - Street 1:18555 N 79TH AVE STE E101
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8392
Mailing Address - Country:US
Mailing Address - Phone:623-487-0947
Mailing Address - Fax:623-487-4897
Practice Address - Street 1:18555 N 79TH AVE STE E101
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8392
Practice Address - Country:US
Practice Address - Phone:623-487-0947
Practice Address - Fax:623-487-4897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty