Organization
THE CHILDREN'S THERAPY CENTER
Active
Parent organization
THE CHILDREN'S THERAPY CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE CHILDREN'S THERAPY CENTER
Authorized official
LISA MARIE MACKELL PT (PRESIDENT)
(484) 787-2267
Entity
Organization
Contact information
Practice address
7001 HERITAGE VILLAGE PLZ, SUITE 175, GAINESVILLE, VA 20155-3065
(703) 291-1254
(571) 248-0304
Mailing address
8348 TRAFORD LN, SUITE 200, SPRINGFIELD, VA 22152-1663
(703) 569-7500
(703) 866-0158
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
2305001607
VA
225XP0200X
Pediatric Occupational Therapist
1457491391
VA
235Z00000X
Speech-Language Pathologist
2202008072
VA
Other
Enumeration date
06/20/2016
Last updated
10/02/2019
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