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General NPI Number Information
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NPI Number | 1366899171
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Entity Type | Organization
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Legal Business Name | NORTH VALLEY PEDIATRIC THERAPY, LLC
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Dates
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Enumeration Date | 05/22/2016
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 1831 W ROSE GARDEN LN STE 4
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City | PHOENIX
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State | AZ
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Zip | 85027-2725
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Country | US
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Telephone | 602-808-9912
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Fax | 602-875-0385
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Provider Business Mailing Address
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Address Line | 1831 W ROSE GARDEN LN STE 4
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City | PHOENIX
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State | AZ
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Zip | 85027-2725
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Country | US
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Telephone | 602-808-9912
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SARAH TRAUTMAN
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Credential |
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Telephone | 602-808-9912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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 | 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 #4
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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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Taxonomy #5
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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