Organization
CHILDREN'S THERAPY CENTER, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA HOUGH OTR/L (PRESIDENT)
(502) 267-4478
Entity
Organization
Contact information
Practice address
13010 EASTGATE PARK WAY STE 101, LOUISVILLE, KY 40223-3984
(502) 244-1210
(502) 473-6798
Mailing address
13010 EASTGATE PARK WAY STE 101, LOUISVILLE, KY 40223-3984
(502) 244-1210
(502) 473-6798
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
225100000X
Physical Therapist
PT-004789
KY
225X00000X
Occupational Therapist
Primary
R1137
KY
235Z00000X
Speech-Language Pathologist
4307
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100354720
—
KY
05
—
7100360790
—
KY
Enumeration date
07/08/2006
Last updated
05/21/2021
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