Provider Demographics
NPI:1245000801
Name:LEARNING TIME THERAPY
Entity type:Organization
Organization Name:LEARNING TIME THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:CARDILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-817-1388
Mailing Address - Street 1:209 E LUZERNE AVE
Mailing Address - Street 2:
Mailing Address - City:LARKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18704-1036
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:209 E LUZERNE AVE
Practice Address - Street 2:
Practice Address - City:LARKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18704-1036
Practice Address - Country:US
Practice Address - Phone:570-817-1388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency