Healthcare Provider Details

I. General information

NPI: 1558637603
Provider Name (Legal Business Name): CURTNER DEVELOPMENTAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2012
Last Update Date: 03/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 W HANCOCK AVE
GILBERT AZ
85233-1407
US

IV. Provider business mailing address

709 W HANCOCK AVE
GILBERT AZ
85233-1407
US

V. Phone/Fax

Practice location:
  • Phone: 480-570-4867
  • Fax:
Mailing address:
  • Phone: 480-570-4867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. REBECCA CURTNER
Title or Position: OWNER
Credential:
Phone: 480-570-4867