Provider Demographics
NPI:1942019740
Name:GROWTH AND GRACE PEDIATRIC OCCUPATIONAL THERAPY, L.L.C.
Entity type:Organization
Organization Name:GROWTH AND GRACE PEDIATRIC OCCUPATIONAL THERAPY, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:RICHELLE
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MS, OTR/L
Authorized Official - Phone:703-969-1467
Mailing Address - Street 1:120 19TH ST N STE 201
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-3219
Mailing Address - Country:US
Mailing Address - Phone:703-969-1467
Mailing Address - Fax:
Practice Address - Street 1:874 FIELDSTOWN CIR
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-1100
Practice Address - Country:US
Practice Address - Phone:703-969-1467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty