Healthcare Provider Details

I. General information

NPI: 1538105598
Provider Name (Legal Business Name): CHILDRENS NEUROTHERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 02/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1087 13TH ST SE
HICKORY NC
28602-4165
US

IV. Provider business mailing address

1087 13TH ST SE
HICKORY NC
28602-4165
US

V. Phone/Fax

Practice location:
  • Phone: 828-267-1688
  • Fax: 828-267-1690
Mailing address:
  • Phone: 828-267-1688
  • Fax: 828-267-1690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNC

VIII. Authorized Official

Name: MS. LAURA JARRETT CRAIG
Title or Position: FINANCIAL DIRECTOR
Credential:
Phone: 828-267-1688