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General NPI Number Information
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NPI Number | 1184246621
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Entity Type | Organization
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Legal Business Name | ACHIEVING MILESTONES PEDIATRIC THERAPY, INC
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Dates
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Enumeration Date | 05/07/2020
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Last Update Date | 05/07/2020
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Provider Practice Location Address
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Address Line | 221 E GLENOAKS BLVD # 225A
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City | GLENDALE
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State | CA
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Zip | 91207-2085
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Country | US
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Telephone | 818-288-3334
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Fax |
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Provider Business Mailing Address
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Address Line | 1018 ELM AVE
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City | GLENDALE
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State | CA
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Zip | 91201-3424
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Country | US
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Telephone | 818-288-3334
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. EDIT KATHY KESHISHYAN
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Credential | OT
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Telephone | 818-288-3334
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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 | 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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Taxonomy #3
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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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