Provider Demographics
NPI:1265833685
Name:THERAPEDS WORKS
Entity Type:Organization
Organization Name:THERAPEDS WORKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:EASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:210-364-7391
Mailing Address - Street 1:4533 LABRADOR DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-4809
Mailing Address - Country:US
Mailing Address - Phone:210-364-7391
Mailing Address - Fax:866-459-0530
Practice Address - Street 1:135 LAIRDS DR
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-7921
Practice Address - Country:US
Practice Address - Phone:210-364-7391
Practice Address - Fax:866-459-0530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112291225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty