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General NPI Number Information
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NPI Number | 1467339929
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Entity Type | Organization
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Legal Business Name | PEDITHRIVE LLC
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 1308 DAFFODIL DRIVE
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City | TEMPLE
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State | TX
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Zip | 76502
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Country | US
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Telephone | 254-500-8956
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Fax |
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Provider Business Mailing Address
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Address Line | 105 BANKS STA # 1200
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7503
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Country | US
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Telephone | 254-500-8956
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Fax |
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Authorized Official
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Title or Position | CO FOUNDER
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Name | DR. ADESHINA SAWYER
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Credential | OTR/L , OTD
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Telephone | 254-500-8956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational 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 | 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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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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