Organization
PEDIATRIC THERAPY AND LEARNING CENTER OF THE NORTHSHORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT ROBERTSON (OWNER)
(504) 930-4476
Entity
Organization
Contact information
Practice address
2033 N HWY 190, SUITE 10A, COVINGTON, LA 70433-8985
(985) 590-4549
(985) 333-1217
Mailing address
2033 N HWY 190, SUITE 10A, COVINGTON, LA 70433-8985
(985) 590-4549
(985) 333-1217
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTT.Z12153
LA
235Z00000X
Speech-Language Pathologist
4981
LA
Other
Enumeration date
06/24/2011
Last updated
08/12/2025
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