Healthcare Provider Details

I. General information

NPI: 1386313732
Provider Name (Legal Business Name): ALL ABOUT KIDS THERAPY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 09/09/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 COURTHOUSE SQUARE
LIBERTY KY
42539
US

IV. Provider business mailing address

PO BOX 834
LIBERTY KY
42539-0834
US

V. Phone/Fax

Practice location:
  • Phone: 606-303-9130
  • Fax:
Mailing address:
  • Phone: 606-303-9130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ALLISON SALLEE
Title or Position: OWNER, SPEECH LANGUAGE PATHOLOGIST
Credential:
Phone: 606-303-9130