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NPI Code Detail

MEDICARE: AUTISM THERAPEUTIC SERVICES

MEDICARE: AUTISM THERAPEUTIC SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist
2225X00000XOccupational Therapist
3235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1730843244
Entity Type Code : Organization
Provider Name (Legal Business Name) : AUTISM THERAPEUTIC SERVICES
Provider Business Mailing Address
First Line : 568 SANDHURST DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-4426
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 102 SUPERIOR DR
Second Line :
City : SPRING LAKE
State : NC
Zip : 28390-3190
Country : US
Telephone Number : 910-484-1711
Fax Number :
Authorized Official
Title or Position : SVP OUTPATIENT PEDIATRICS
Name : TERRA RAE SCOTT
Credential :
Telephone Number : 303-437-4364
Provider Enumeration Date : 10/30/2021
Last Update Date : 11/10/2023

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Directions to “AUTISM THERAPEUTIC SERVICES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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