Organization
KM PEDIATRIC THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORAINE ALLEN MA, CCC, SLP (OWNER)
(919) 465-4424
Entity
Organization
Contact information
Practice address
103 FREHOLD CT, CARY, NC 27519-7372
(919) 465-4424
(919) 465-4427
Mailing address
103 FREHOLD CT, CARY, NC 27519-7372
(919) 465-4424
(919) 465-4427
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017GM
BLUE CROSS BLUE SHIELD
NC
05
—
7211594
—
NC
Enumeration date
05/05/2006
Last updated
02/23/2010
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