Provider Demographics
NPI:1669592952
Name:KIDS THERAPY UNLIMITED, INC.
Entity type:Organization
Organization Name:KIDS THERAPY UNLIMITED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:JONES
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:MSE-CCC
Authorized Official - Phone:813-662-1106
Mailing Address - Street 1:605 W BLOOMINGDALE AVE
Mailing Address - Street 2:H
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-7444
Mailing Address - Country:US
Mailing Address - Phone:813-662-1106
Mailing Address - Fax:813-661-7661
Practice Address - Street 1:605 W BLOOMINGDALE AVE
Practice Address - Street 2:H
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-7444
Practice Address - Country:US
Practice Address - Phone:813-662-1106
Practice Address - Fax:813-661-7661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 191235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty