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General NPI Number Information
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NPI Number | 1952520397
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Entity Type | Organization
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Legal Business Name | KIDS THERAPY WORKS, LLC
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 10/17/2007
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Provider Practice Location Address
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Address Line | 600 N PINE ISLAND RD SUITE 450
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City | PLANTATION
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State | FL
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Zip | 33324-1393
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Country | US
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Telephone | 954-315-0139
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Fax |
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Provider Business Mailing Address
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Address Line | 600 N PINE ISLAND RD SUITE 450
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City | PLANTATION
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State | FL
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Zip | 33324-1393
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Country | US
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Telephone | 954-315-0139
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MS. KAREN MARIE JORDAN
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Credential | SLP
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Telephone | 954-599-4185
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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 | SA6628
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License Number State | FL
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