Organization
PEDIATRIC THERAPY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDICE MOREE GRAY M.A., CCC-SLP (OWNER)
(225) 921-7216
Entity
Organization
Contact information
Practice address
1034 ELIZABETH DR, BATON ROUGE, LA 70815-4509
(225) 921-7216
(225) 927-4059
Mailing address
1034 ELIZABETH DR, BATON ROUGE, LA 70815-4509
(225) 921-7216
(225) 927-4059
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4906
LA
Other
Enumeration date
04/24/2008
Last updated
02/17/2010
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