Provider Demographics
NPI:1740667245
Name:PEDIATRIC AND ADULT THERAPY SERVICES, L.L.C.
Entity type:Organization
Organization Name:PEDIATRIC AND ADULT THERAPY SERVICES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KIMIKO
Authorized Official - Middle Name:MUNIZ
Authorized Official - Last Name:PEARS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:251-379-0580
Mailing Address - Street 1:3351 TORREY DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-3563
Mailing Address - Country:US
Mailing Address - Phone:251-379-0580
Mailing Address - Fax:
Practice Address - Street 1:3351 TORREY DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-3563
Practice Address - Country:US
Practice Address - Phone:251-379-0580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-04
Last Update Date:2020-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3645235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty