Organization
KIDS SPEECH, PHYSICAL, AND OCCUPATIONAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNIE BOUCHEREAU (PRESIDENT)
(954) 445-3064
Entity
Organization
Contact information
Practice address
1726 DAVENPORT DR, NEW PORT RICHEY, FL 34655-4228
(727) 493-2393
Mailing address
1726 DAVENPORT DR, NEW PORT RICHEY, FL 34655-4228
(727) 493-2393
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/26/2023
Last updated
09/27/2023
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