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General NPI Number Information
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NPI Number | 1205376399
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Entity Type | Organization
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Legal Business Name | KIDZ THERAPY SERVICES, PLLC
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Dates
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Enumeration Date | 03/08/2017
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Last Update Date | 03/08/2017
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Provider Practice Location Address
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Address Line | 191 ARROW ST
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City | OCEANSIDE
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State | NY
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Zip | 11572-4237
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Country | US
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Telephone | 516-670-6800
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Fax | 516-594-5666
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Provider Business Mailing Address
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Address Line | 191 ARROW ST
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City | OCEANSIDE
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State | NY
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Zip | 11572-4237
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Country | US
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Telephone | 516-670-6800
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Fax | 516-594-5666
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MS. NANCY LINDA PERKINS
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Credential | LMSW
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Telephone | 516-670-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 039682-1
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License Number State | NY
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