Healthcare Provider Details

I. General information

NPI: 1043390800
Provider Name (Legal Business Name): KIDS 1ST THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 01/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 MARKET ST
HENDERSON KY
42420-4855
US

IV. Provider business mailing address

1040 MARKET ST
HENDERSON KY
42420-4855
US

V. Phone/Fax

Practice location:
  • Phone: 270-831-1199
  • Fax: 270-831-1199
Mailing address:
  • Phone: 270-831-1199
  • Fax: 270-831-1199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number003702
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberR2792
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number12-014
License Number StateKY

VIII. Authorized Official

Name: MRS. MELISSA DAWN ABSHIER
Title or Position: PARTNER/PHYSICAL THERAPIST
Credential: P.T.
Phone: 270-831-1199