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General NPI Number Information
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NPI Number | 1598379794
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Entity Type | Organization
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Legal Business Name | BUILDING PATHWAYS THERAPY LLC
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Dates
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Enumeration Date | 09/04/2020
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Last Update Date | 09/04/2020
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Provider Practice Location Address
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Address Line | 2124 CHESHIRE BRIDGE RD NE APT 2006
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City | ATLANTA
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State | GA
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Zip | 30324-5731
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Country | US
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Telephone | 863-651-3684
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Fax |
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Provider Business Mailing Address
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Address Line | 7200 MYSTIC BROOK WAY
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City | DAVENPORT
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State | FL
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Zip | 33896-6703
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Country | US
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Telephone | 186-365-1368
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | JUDLANDE GUERVIL
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Credential | PT, DPT
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Telephone | 863-651-3684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical 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 | 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 #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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