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General NPI Number Information
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NPI Number | 1043976277
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Entity Type | Organization
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Legal Business Name | AUTISM THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 11/11/2021
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 3649 CAPE CENTER DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-4457
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Country | US
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Telephone | 910-484-1711
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Fax |
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Provider Business Mailing Address
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Address Line | 568 SANDHURST DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-4426
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SVP OUTPATIENT PEDIATRICS
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Name | TERRA RAE SCOTT
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Credential |
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Telephone | 303-437-4364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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