Organization
PEDIATRIC SPECIALTY ASSOCIATES, INC
Active
Organization
PEDIATRIC SPECIALTY ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA HOLTZ (OWNER/DIRECTOR)
(317) 405-9016
Entity
Organization
Contact information
Practice address
6437 RUCKER RD STE D, INDIANAPOLIS, IN 46220-4868
(317) 405-9016
(888) 654-4116
Mailing address
6437 RUCKER RD STE D, INDIANAPOLIS, IN 46220-4868
(317) 405-9016
(888) 654-4116
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200717440
—
IN
Enumeration date
11/16/2006
Last updated
05/13/2022
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