Provider Demographics
NPI:1366226235
Name:THE THERAPY TREE FOR PEDIATRICS, LLC
Entity type:Organization
Organization Name:THE THERAPY TREE FOR PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-331-0846
Mailing Address - Street 1:618 BOWENS MILL RD SW
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31533-3926
Mailing Address - Country:US
Mailing Address - Phone:912-331-0846
Mailing Address - Fax:678-792-4894
Practice Address - Street 1:618 BOWENS MILL RD SW
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533-3926
Practice Address - Country:US
Practice Address - Phone:912-331-0846
Practice Address - Fax:678-792-4894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-22
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty