Provider Demographics
NPI:1477223246
Name:KIDS-AT-PLAY PEDIATRIC THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:KIDS-AT-PLAY PEDIATRIC THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:MILLER
Authorized Official - Last Name:DOWDY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:615-319-5132
Mailing Address - Street 1:130 HILLCREST DR STE 102
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-5064
Mailing Address - Country:US
Mailing Address - Phone:931-488-4384
Mailing Address - Fax:931-444-5646
Practice Address - Street 1:130 HILLCREST DR STE 102
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5064
Practice Address - Country:US
Practice Address - Phone:931-488-4384
Practice Address - Fax:931-444-5646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech