Provider Demographics
NPI:1316188139
Name:KID POWER THERAPY SERVICES, INC
Entity Type:Organization
Organization Name:KID POWER THERAPY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:513-575-5431
Mailing Address - Street 1:5989 MEIJER DR STE 4
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-1544
Mailing Address - Country:US
Mailing Address - Phone:523-575-5431
Mailing Address - Fax:
Practice Address - Street 1:5989 MEIJER DR STE 4
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1544
Practice Address - Country:US
Practice Address - Phone:523-575-5431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT 003417225X00000X
OHOT-4832225X00000X
OHOT-003871225X00000X
OHOT-008651225X00000X
OHSP-5748235Z00000X
OHSP-8033235Z00000X
OHSP-5756235Z00000X
OHSP10482235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty