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Organization

EPIC PEDIATRIC THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY GORDON (COTA)
(786) 797-0382
Entity
Organization

Contact information

Practice address
6155 SIENNA TRL APT 612, BEAUMONT, TX 77708-4357
(786) 797-0382
Mailing address
6155 SIENNA TRL APT 612, BEAUMONT, TX 77708-4357
(786) 797-0382

Taxonomy

Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
212133
TX

Other

Enumeration date
08/03/2014
Last updated
08/03/2014
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