Provider Demographics
NPI:1457184582
Name:DANDELION KIDS THERAPY SERVICES PLLC
Entity type:Organization
Organization Name:DANDELION KIDS THERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:SIVORI
Authorized Official - Suffix:
Authorized Official - Credentials:MOT/L
Authorized Official - Phone:512-826-3225
Mailing Address - Street 1:6305 WALEBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78739-1571
Mailing Address - Country:US
Mailing Address - Phone:512-826-3225
Mailing Address - Fax:
Practice Address - Street 1:6305 WALEBRIDGE LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78739-1571
Practice Address - Country:US
Practice Address - Phone:512-826-3225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty