Organization
INTEGRATIVE PEDIATRIC THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANAL RIZK (FOUNDER)
(734) 720-7694
Entity
Organization
Contact information
Practice address
19117 ALLEN RD STE C, BROWNSTOWN TWP, MI 48183-1066
(734) 720-7694
Mailing address
19117 ALLEN RD STE C, BROWNSTOWN TWP, MI 48183-1066
(734) 720-7694
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
Other
Enumeration date
11/05/2019
Last updated
03/08/2021
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