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NPI Code Detail

MEDICARE: KM PEDIATRIC THERAPY, INC.

MEDICARE: KM PEDIATRIC THERAPY, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2225X00000XOccupational Therapist
3235Z00000XSpeech-Language Pathologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1017GMOTHERNCBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457309932
Entity Type Code : Organization
Provider Name (Legal Business Name) : KM PEDIATRIC THERAPY, INC.
Provider Business Mailing Address
First Line : 103 FREHOLD CT
Second Line :
City : CARY
State : NC
Zip : 27519-7372
Country : US
Telephone Number : 919-465-4424
Fax Number : 919-465-4427
Provider Business Practice Location Address
First Line : 103 FREHOLD CT
Second Line :
City : CARY
State : NC
Zip : 27519-7372
Country : US
Telephone Number : 919-465-4424
Fax Number : 919-465-4427
Authorized Official
Title or Position : OWNER
Name : LORAINE ALLEN
Credential : MA, CCC, SLP
Telephone Number : 919-465-4424
Provider Enumeration Date : 05/05/2006
Last Update Date : 02/23/2010

Similar Medicare Providers

1316379589 — MELEAH PARRISH MA, CCC-SLP
Practice Location Address:
103 FREHOLD CT
CARY, NC
27519-7372
Practice Phone: 919-465-4424
Practice Fax: 919-465-4427
1316086937 — TAMMY GREINER MS, CCC-SLP
Practice Location Address:
103 FREHOLD CT
CARY, NC
27519-7372
Practice Phone: 919-465-4424
Practice Fax: 919-465-4427
1548309487 — SHEILA BRENNAN OTR, L
Practice Location Address:
103 FREHOLD CT
CARY, NC
27519-7372
Practice Phone: 919-465-4424
Practice Fax: 919-465-4427
1255470860 — TERRI HALE MS, CCC-SLP
Practice Location Address:
103 FREHOLD CT
CARY, NC
27519-7372
Practice Phone: 919-465-4424
Practice Fax: 919-465-4427
1639218209 — KATE JOHNSON MS, CCC-SLP
Practice Location Address:
103 FREHOLD CT
CARY, NC
27519-7372
Practice Phone: 919-465-4424
Practice Fax: 919-465-4427
1871632612 — LORAINE ALLEN MA, CCC-SLP
Practice Location Address:
103 FREHOLD CT
CARY, NC
27519-7372
Practice Phone: 919-465-4424
Practice Fax: 919-465-4427

Directions to “KM PEDIATRIC THERAPY, INC. ” Practice Location

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