Organization
LEAPS AHEAD PEDIATRIC THERAPIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER YATES OTD (MEMBER/OWNER)
(469) 346-9573
Entity
Organization
Contact information
Practice address
2908 E AVALON DR, SPRINGFIELD, MO 65804-4155
(469) 491-9282
Mailing address
2908 E AVALON DR, SPRINGFIELD, MO 65804-4155
(469) 491-9282
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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