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Organization
KREDO HOME THERAPY LLC.
Active
Organization
KREDO HOME THERAPY LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON CORNELL (DIRECTOR)
(407) 848-6912
Entity
Organization
Contact information
Practice address
14328 MAGNOLIA RIDGE LOOP, WINTER GARDEN, FL 34787-5353
(407) 906-1942
Mailing address
14328 MAGNOLIA RIDGE LOOP, WINTER GARDEN, FL 34787-5353
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
02/10/2019
Last updated
02/10/2019
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