Provider Demographics
NPI:1700913522
Name:KIDZTHERAPY NETWORKS INC
Entity Type:Organization
Organization Name:KIDZTHERAPY NETWORKS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:PANAGOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-205-5551
Mailing Address - Street 1:5975 PARKWAY NORTH BLVD
Mailing Address - Street 2:SUITE 300B
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-1226
Mailing Address - Country:US
Mailing Address - Phone:770-205-5551
Mailing Address - Fax:
Practice Address - Street 1:5975 PARKWAY NORTH BLVD
Practice Address - Street 2:SUITE 300B
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-1226
Practice Address - Country:US
Practice Address - Phone:770-205-5551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251P0200X
GAOT003813225XP0200X
GASLP005951235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty