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General NPI Number Information
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NPI Number | 1457094104
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Entity Type | Organization
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Legal Business Name | KID'S PATH PEDIATRIC THERAPY SERVICES
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Dates
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Enumeration Date | 04/19/2022
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 1444 E FLORENCE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90001-2109
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Country | US
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Telephone | 310-210-3196
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Fax |
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Provider Business Mailing Address
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Address Line | 2355 WESTWOOD BLVD # 965
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City | LOS ANGELES
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State | CA
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Zip | 90064-2109
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | TIFFANY NAVIDBAKHSH
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Credential |
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Telephone | 310-824-3594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #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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