Provider Demographics
NPI:1750693313
Name:PEDIATRIC AND ADULT THERAPY ASSOCIATES INCORPORATED
Entity type:Organization
Organization Name:PEDIATRIC AND ADULT THERAPY ASSOCIATES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:859-979-1999
Mailing Address - Street 1:114 DENNIS DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2917
Mailing Address - Country:US
Mailing Address - Phone:859-608-8828
Mailing Address - Fax:859-309-9886
Practice Address - Street 1:114 DENNIS DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2917
Practice Address - Country:US
Practice Address - Phone:859-608-8828
Practice Address - Fax:859-309-9886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-11
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty