Provider Demographics
NPI:1376789917
Name:CHILD THERAPY HEALING OASIS, PLLC
Entity Type:Organization
Organization Name:CHILD THERAPY HEALING OASIS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ADYANA
Authorized Official - Middle Name:CONSTANCE MARIE
Authorized Official - Last Name:BRASHEAR
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:512-468-9707
Mailing Address - Street 1:8810 THUNDERBIRD RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78736-8006
Mailing Address - Country:US
Mailing Address - Phone:512-761-1707
Mailing Address - Fax:512-236-5183
Practice Address - Street 1:8810 THUNDERBIRD RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78736-8006
Practice Address - Country:US
Practice Address - Phone:512-761-1707
Practice Address - Fax:512-236-5183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-04
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty