Organization
PEDIATRIC THERAPIES OF SE GA, LLC
Active
Organization
PEDIATRIC THERAPIES OF SE GA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN MICHELLE PARKS MS, OTR/L (CEO)
(912) 342-8875
Entity
Organization
Contact information
Practice address
4212 CORAL PARK DR, BRUNSWICK, GA 31520-3016
(912) 342-8875
(912) 265-0041
Mailing address
4212 CORAL PARK DR, BRUNSWICK, GA 31520-3016
(912) 342-8875
(912) 265-0041
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
OT001375
GA
225XP0200X
Pediatric Occupational Therapist
OT002198
GA
225XP0200X
Pediatric Occupational Therapist
OT005680
GA
235Z00000X
Speech-Language Pathologist
SLP001592
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003116394B
—
GA
Enumeration date
11/14/2011
Last updated
06/19/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up