Organization
BACKYARD TREEHOUSE PEDIATRIC THERAPY CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BECKY DANCHO OTR/L (PRESIDENT)
(610) 751-4158
Entity
Organization
Contact information
Practice address
25 S. BROAD ST, SUITE 101, NAZARETH, PA 18064-2167
(610) 751-0533
Mailing address
39 PALOMINO CIR, BANGOR, PA 18013-9517
(610) 751-4158
(610) 588-0164
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
08/09/2010
Last updated
08/21/2010
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