Provider Demographics
NPI:1437372125
Name:LAKEWOOD PEDIATRIC THERAPY
Entity Type:Organization
Organization Name:LAKEWOOD PEDIATRIC THERAPY
Other - Org Name:THE SENSORY INTEGRATION CENTER OF COPPELL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCCSLP
Authorized Official - Phone:972-745-8087
Mailing Address - Street 1:1203 CRESTSIDE DRIVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-4952
Mailing Address - Country:US
Mailing Address - Phone:972-745-8087
Mailing Address - Fax:972-745-4448
Practice Address - Street 1:1203 CRESTSIDE DRIVE
Practice Address - Street 2:SUITE 150
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-4952
Practice Address - Country:US
Practice Address - Phone:972-745-8087
Practice Address - Fax:972-745-4448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty