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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