Organization
SPECTRUM PEDIATRIC THERAPIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA DEKLE (OWNER)
(318) 305-0476
Entity
Organization
Contact information
Practice address
114 N MAIN ST, MARKSVILLE, LA 71351-2406
(318) 597-5180
Mailing address
114 N MAIN ST, MARKSVILLE, LA 71351-2406
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
224ZF0002X
Feeding, Eating & Swallowing Occupational Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
01/11/2019
Last updated
01/11/2019
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