Provider Demographics
NPI:1376943498
Name:CHILDREN'S THERAPY SPECIALISTS
Entity Type:Organization
Organization Name:CHILDREN'S THERAPY SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMILIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MHS CCC-SLP
Authorized Official - Phone:602-384-0815
Mailing Address - Street 1:3727 W SAN JUAN AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85019-2113
Mailing Address - Country:US
Mailing Address - Phone:602-384-0815
Mailing Address - Fax:
Practice Address - Street 1:3727 W SAN JUAN AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85019-2113
Practice Address - Country:US
Practice Address - Phone:602-384-0815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health