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Organization

CHILDREN'S TL

Active
Other names
Geaux Play Pediatric Therapy Services
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY BOENIG D'AQUILLA (OWNER)
(225) 245-5170
Entity
Organization

Contact information

Practice address
5637 COMMERCE STREET, ST. FRANCISVILLE, LA 70775
(225) 245-5170
Mailing address
PO BOX 1593, SAINT FRANCISVILLE, LA 70775-1593
(225) 245-5170
(225) 308-3223

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
225X00000X
Occupational Therapist
Z12040
LA
235Z00000X
Speech-Language Pathologist
Primary
4527
LA

Other

Enumeration date
11/22/2016
Last updated
08/21/2020
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