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General NPI Number Information
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NPI Number | 1134638455
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Entity Type | Organization
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Legal Business Name | ABILITIES UNITED
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Dates
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Enumeration Date | 09/29/2017
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Last Update Date | 09/29/2017
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Provider Practice Location Address
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Address Line | 3864 MIDDLEFIELD RD
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City | PALO ALTO
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State | CA
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Zip | 94303-4716
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Country | US
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Telephone | 650-494-0550
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Fax | 650-855-9710
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Provider Business Mailing Address
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Address Line | 525 E CHARLESTON RD
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City | PALO ALTO
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State | CA
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Zip | 94306-4247
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Country | US
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Telephone | 650-494-0550
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Fax | 650-855-9710
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | CHARLIE WEIDANZ
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Credential |
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Telephone | 650-618-3312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric 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 | 225XP0200X
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Taxonomy Name | Pediatric 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 | CA
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