Provider Demographics
NPI:1669977468
Name:DISTINCT ABILITIES ACADEMIC PRESCHOOL, LLC
Entity type:Organization
Organization Name:DISTINCT ABILITIES ACADEMIC PRESCHOOL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:CONNATSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-770-6215
Mailing Address - Street 1:14045 SPACE CENTER BLVD.
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062
Mailing Address - Country:US
Mailing Address - Phone:281-488-0436
Mailing Address - Fax:281-488-0102
Practice Address - Street 1:14045 SPACE CENTER BLVD.
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062
Practice Address - Country:US
Practice Address - Phone:281-488-0436
Practice Address - Fax:281-488-0102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty