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Contact Information

BLACK'S PEDIATRIC THERAPY, INC.
4502 SUMMER GATE CT.
GAINESVILLE, GA30506
 Phone: 770-378-5986
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

225XP0200X 67 Occupational Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for BLACKS PEDIATRIC THERAPY INC · (Female)

NPI Number 1477754067
Status Active
Credentials
Entity Individual
Enumeration date 05/30/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 003199
  • GA Other 10038361 AMERIGROUP- TINA
  • GA Other 10047944 AMERIGROUP-BETH CHAMBERS
  • GA Other 307327 TINA- WELLCARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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