Organization
KIDOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUBA PATLAKH (PRESIDENT)
(267) 968-1707
Entity
Organization
Contact information
Practice address
928 JAYMOR RD STE C-150, SOUTHAMPTON, PA 18966-3832
(215) 330-4116
Mailing address
928 JAYMOR RD STE C-150, SOUTHAMPTON, PA 18966-3832
(215) 330-4116
(215) 330-4118
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
184704659
PA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/08/2014
Last updated
11/04/2022
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