Organization
EXCEPTIONAL KIDZ REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA LASALLE (OWNER)
(215) 613-6523
Entity
Organization
Contact information
Practice address
3 BRIDGE ST, PHYSICAL THERAPY SUITE, CARTHAGE, NY 13619-1360
(215) 613-6523
Mailing address
14500 BUSTLETON AVE, SUITE 1A, PHILADELPHIA, PA 19116-1188
(215) 631-6523
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/24/2014
Last updated
01/27/2014
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