Provider Demographics
NPI:1508373085
Name:CHILDREN'S THERAPY ZONE, INC
Entity Type:Organization
Organization Name:CHILDREN'S THERAPY ZONE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH AND LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAYOMY
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:VILLAFANE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:954-753-7650
Mailing Address - Street 1:11523 NW 6TH CT
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-4117
Mailing Address - Country:US
Mailing Address - Phone:954-753-7650
Mailing Address - Fax:954-753-7650
Practice Address - Street 1:11523 NW 6TH CT
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-4117
Practice Address - Country:US
Practice Address - Phone:954-753-7650
Practice Address - Fax:954-753-7650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency