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General NPI Number Information
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NPI Number | 1720327091
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Entity Type | Organization
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Legal Business Name | CUTTING EDGE PEDIATRIC THERAPY
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Dates
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Enumeration Date | 02/06/2013
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Last Update Date | 06/16/2023
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Provider Practice Location Address
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Address Line | 900 JUNCTION DR
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City | ALLEN
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State | TX
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Zip | 75013-5290
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Country | US
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Telephone | 469-675-3153
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Fax | 469-675-3154
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Provider Business Mailing Address
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Address Line | 900 JUNCTION DR
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City | ALLEN
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State | TX
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Zip | 75013-5290
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Country | US
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Telephone | 469-675-3153
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Fax | 469-675-3154
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | KATHERINE LUNDGREN
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Credential |
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Telephone | 469-675-3153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 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 #3
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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 #4
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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 #5
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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 #6
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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 #7
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 108093
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License Number State | TX
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