Organization
PEDIATRIC THERAPY PARTNERS, INC.
Active
Organization
PEDIATRIC THERAPY PARTNERS, INC.
Active
Other names
Pediatric Partners, Pediatric Partners Neurobehavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PATRICIA RODENBERG-ROBERTS (VP & SR. ASST GENERAL COUNSEL)
(952) 836-2234
Entity
Organization
Contact information
Practice address
419 ATLANTIC AVE, THIEF RIVER FALLS, MN 56701-2044
(701) 232-2340
Mailing address
3060 FRONTIER WAY SOUTH, FARGO, ND 58104
(701) 232-2340
(701) 232-2330
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
—
—
106S00000X
Behavior Technician
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457479958
—
MN
05
—
1462276
—
ND
Enumeration date
03/26/2007
Last updated
01/26/2025
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