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General NPI Number Information
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NPI Number | 1851782510
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Entity Type | Organization
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Legal Business Name | ADVANCED PEDIATRIC THERAPIES
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Dates
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Enumeration Date | 02/16/2015
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Last Update Date | 02/16/2015
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Provider Practice Location Address
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Address Line | 1025 ROBERTA LN
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City | SPARKS
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State | NV
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Zip | 89431-1893
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Country | US
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Telephone | 775-825-4744
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Fax | 775-351-1644
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Provider Business Mailing Address
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Address Line | 1025 ROBERTA LN
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City | SPARKS
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State | NV
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Zip | 89431-1893
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Country | US
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Telephone | 775-825-4744
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Fax | 775-351-1644
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. COLLEEN ANN BAKER
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Credential |
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Telephone | 775-825-4744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP-1779
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License Number State | NV
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