Provider Demographics
NPI:1477670578
Name:KIDS-N-ACTION PEDIATRIC THERAPY
Entity Type:Organization
Organization Name:KIDS-N-ACTION PEDIATRIC THERAPY
Other - Org Name:KIDS-N-ACTION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:HARRIETT
Authorized Official - Middle Name:L
Authorized Official - Last Name:DUMAS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR L
Authorized Official - Phone:478-731-5235
Mailing Address - Street 1:224 TROON W
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-4949
Mailing Address - Country:US
Mailing Address - Phone:478-731-5235
Mailing Address - Fax:478-475-1010
Practice Address - Street 1:4501 RUSSELL PARKWAY
Practice Address - Street 2:SUITE 20
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31210
Practice Address - Country:US
Practice Address - Phone:478-953-0077
Practice Address - Fax:478-475-1010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT002530225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty