Organization
FAIRVIEW THERAPY
Active
Other names
Mini Miracles Pediatric Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN BROWN (OWNER)
(405) 247-0285
Entity
Organization
Contact information
Practice address
2214 E FAIRVIEW AVE, JOHNSON CITY, TN 37601-2860
(423) 928-6464
Mailing address
4334 NW EXPRESSWAY STE 187, OKLAHOMA CITY, OK 73116-1515
(405) 247-0285
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106H00000X
Marriage & Family Therapist
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
03/12/2021
Last updated
06/10/2024
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