Healthcare Provider Details

I. General information

NPI: 1740334135
Provider Name (Legal Business Name): CAROLINA PEDIATRIC THERAPY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8321 OLD PONDEROSA CIR
RALEIGH NC
27603-8721
US

IV. Provider business mailing address

8321 OLD PONDEROSA CIR
RALEIGH NC
27603-8721
US

V. Phone/Fax

Practice location:
  • Phone: 919-622-7496
  • Fax: 919-779-7880
Mailing address:
  • Phone: 919-622-7496
  • Fax: 919-779-7880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MELISSA MILEY
Title or Position: PRESIDENT
Credential:
Phone: 919-622-7496