Basic Information
| Provider Information | |||||||||
| NPI: | 1811478910 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHILDREN FIRST THERAPY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 82322 BEAR CREEK ROAD | ||||||||
| Address2: | |||||||||
| City: | CRESWELL | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412217458 | ||||||||
| FaxNumber: | 5418332616 | ||||||||
| Practice Location | |||||||||
| Address1: | 82322 BEAR CREEK ROAD | ||||||||
| Address2: | |||||||||
| City: | CRESWELL | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412217458 | ||||||||
| FaxNumber: | 5418332616 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2018 | ||||||||
| LastUpdateDate: | 08/27/2018 | ||||||||
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| AuthorizedOfficialLastName: | TAYLOR | ||||||||
| AuthorizedOfficialFirstName: | JULIA | ||||||||
| AuthorizedOfficialMiddleName: | DAVIS | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 5412217458 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | OTR/L | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XP0200X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
No ID Information.