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Organization
LIGHTHOUSE PEDIATRIC THERAPY PARTNERS
Active
Organization
LIGHTHOUSE PEDIATRIC THERAPY PARTNERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALICIA CAPEN MS, CCC-SLP (OWNER)
(727) 643-4049
Entity
Organization
Contact information
Practice address
412 12TH AVE N, ST PETERSBURG, FL 33701-1120
(727) 344-9472
Mailing address
412 12TH AVE N, ST PETERSBURG, FL 33701-1120
(727) 344-9472
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/24/2020
Last updated
06/24/2020
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