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General NPI Number Information
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NPI Number | 1174280325
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Entity Type | Organization
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Legal Business Name | ACHIEVE PEDIATRIC THERAPY, INC
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Dates
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Enumeration Date | 11/23/2021
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Last Update Date | 11/23/2021
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Provider Practice Location Address
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Address Line | 11602 LAKE UNDERHILL ROAD, SUITE 129
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City | ORLANDO
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State | FL
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Zip | 32825
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Country | US
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Telephone | 407-277-5400
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Fax | 321-281-4942
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Provider Business Mailing Address
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Address Line | 11602 LAKE UNDERHILL ROAD, SUITE 129
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City | ORLANDO
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State | FL
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Zip | 32825
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Country | US
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Telephone | 407-277-5400
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Fax | 321-281-4942
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Authorized Official
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Title or Position | OWNER/OCCUPATIONAL THERAPIST
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Name | HEATHER B GRAY
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Credential | O.T.
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Telephone | 407-277-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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