Provider Demographics
NPI:1982825774
Name:THE CENTER FOR PEDIATRIC THERAPY,LLC
Entity Type:Organization
Organization Name:THE CENTER FOR PEDIATRIC THERAPY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, LOTR
Authorized Official - Phone:985-449-0944
Mailing Address - Street 1:1713 RIDGEFIELD RD STE C
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-4399
Mailing Address - Country:US
Mailing Address - Phone:985-449-0944
Mailing Address - Fax:985-449-0945
Practice Address - Street 1:1713 RIDGEFIELD RD STE C
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-4399
Practice Address - Country:US
Practice Address - Phone:985-449-0944
Practice Address - Fax:985-449-0945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty