Provider Demographics
NPI:1679646426
Name:CHAPEL HILL PEDIATRIC THERAPY INC
Entity Type:Organization
Organization Name:CHAPEL HILL PEDIATRIC THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-995-2345
Mailing Address - Street 1:250 OLD FOREST CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-5420
Mailing Address - Country:US
Mailing Address - Phone:770-995-2345
Mailing Address - Fax:678-392-4401
Practice Address - Street 1:250 OLD FOREST CREEK DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5420
Practice Address - Country:US
Practice Address - Phone:770-995-2345
Practice Address - Fax:678-392-4401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty