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General NPI Number Information
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NPI Number | 1689371148
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Entity Type | Organization
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Legal Business Name | PAISLEY PEDIATRIC THERAPY
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Dates
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Enumeration Date | 02/14/2023
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Last Update Date | 07/06/2023
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Provider Practice Location Address
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Address Line | 830 GLENWOOD AVE SE STE 510-357
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City | ATLANTA
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State | GA
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Zip | 30316-1966
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Country | US
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Telephone | 770-626-0971
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Fax |
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Provider Business Mailing Address
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Address Line | 830 GLENWOOD AVE SE STE 510-357
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City | ATLANTA
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State | GA
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Zip | 30316-1966
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Country | US
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Telephone | 770-626-0971
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | KATHARINE DONEGAN
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Credential | M.ED., CCC-SLP
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Telephone | 404-290-7955
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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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