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General NPI Number Information
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NPI Number | 1619252814
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Entity Type | Organization
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Legal Business Name | KIDS RELATE
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Dates
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Enumeration Date | 10/19/2011
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Last Update Date | 05/07/2012
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Provider Practice Location Address
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Address Line | 1018 1/2 HAMILTON ST
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City | PHILADELPHIA
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State | PA
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Zip | 19123-3727
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Country | US
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Telephone | 267-978-0571
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Fax |
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Provider Business Mailing Address
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Address Line | 1018 1/2 HAMILTON ST
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City | PHILADELPHIA
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State | PA
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Zip | 19123-3727
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Country | US
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Telephone | 267-978-0571
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. TAMARA SEPE
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Credential | M.S./CCC-SLP
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Telephone | 267-978-0571
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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 | 225100000X
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Taxonomy Name | Physical 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 | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | SL007158
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License Number State | PA
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