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General NPI Number Information
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NPI Number | 1770001521
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Entity Type | Organization
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Legal Business Name | KW PEDS & ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/31/2017
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Last Update Date | 07/15/2021
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Provider Practice Location Address
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Address Line | 4012 RAINTREE RD STE 100B
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City | CHESAPEAKE
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State | VA
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Zip | 23321-3741
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Country | US
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Telephone | 757-630-9236
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Fax |
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Provider Business Mailing Address
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Address Line | 1317 KING ARTHUR CT
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City | CHESAPEAKE
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State | VA
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Zip | 23323-2819
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Country | US
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Telephone | 757-630-9236
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/ OWNER
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Name | MRS. SHERITA N QUICK-WILLIAMS
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Credential |
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Telephone | 757-630-0090
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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 | 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 #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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