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General NPI Number Information
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NPI Number | 1568798544
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Entity Type | Organization
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Legal Business Name | KIDS CHOICE LLC
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Dates
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Enumeration Date | 10/26/2009
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 8561 MARKET ST
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City | BOARDMAN
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State | OH
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Zip | 44512-6727
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Country | US
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Telephone | 330-953-2383
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Fax | 330-953-2384
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Provider Business Mailing Address
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Address Line | 2890 SE RIVER RD
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City | BERLIN CENTER
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State | OH
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Zip | 44401-9779
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Country | US
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Telephone | 330-550-3003
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MRS. DEANDRA L. DEMES
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Credential |
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Telephone | 330-550-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP9491
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License Number State | OH
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