Organization
CHILDREN'S THERAPY ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD A. BOULANGER OTR/L (CO-OWNER)
(941) 756-1003
Entity
Organization
Contact information
Practice address
3911 GOLF PARK LOOP, SUITE #105, BRADENTON, FL 34203-3453
(941) 756-1003
(941) 756-6003
Mailing address
3911 GOLF PARK LOOP, SUITE #105, BRADENTON, FL 34203-3453
(941) 756-1003
(941) 756-6003
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
173360
WELLCARE
FL
01
—
Y902F
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/25/2006
Last updated
09/11/2025
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