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General NPI Number Information
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NPI Number | 1700192952
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Entity Type | Organization
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Legal Business Name | THERAPYWORKS PEDIATRIC CENTER LLC
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Dates
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Enumeration Date | 08/25/2010
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Last Update Date | 09/21/2022
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Provider Practice Location Address
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Address Line | 130 VETERINARY WAY STE 3
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City | LEESBURG
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State | GA
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Zip | 31763-5667
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Country | US
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Telephone | 229-496-5222
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Fax | 229-219-7914
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Provider Business Mailing Address
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Address Line | 130 VETERINARY WAY STE 3
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City | LEESBURG
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State | GA
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Zip | 31763-5667
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Country | US
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Telephone | 229-496-5222
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Fax | 229-219-7914
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Authorized Official
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Title or Position | OWNER/CEO
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Name | LESLIE RAWLINGS
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Credential |
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Telephone | 229-496-5222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 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 #4
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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 #5
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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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