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JACOB'S LADDER NEURODEVELOPMENTAL LEARNING CENTER

Professional

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Contact Information

JACOB'S LADDER NEURODEVELOPMENTAL LEARNING CENTER
407 HARDSCRABBLE RD
ROSWELL, GA  30075-1417
 Phone: 770-998-1017
 Fax: 770-998-3258
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Professional

 101YP2500X
 

Clinical

 1041C0700X 80 Licensed Clinical Social Worker
 

Mental Health

 101YM0800X
 

Pediatrics

 2251P0200X 65 Physical Therapist in Private Practice
 

Pediatrics

 225XP0200X 67 Occupational Therapist in Private Practice
 

School

 103TS0200X 62 Psychologist, Clinical
 

Speech-Language Pathologist

 235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for JACOB'S LADDER NEURODEVELOPMENTAL LEARNING CENTER

NPI # 1871818641
LBN Legal business name JACOB'S LADDER NEURODEVELOPMENTAL LEARNING CENTER
Authorized official AMY O'DELL - (FOUNDER/DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 04/05/2010
Last updated 11/23/2015 - About 11 years ago
Identifiers
GA License # 09634048
GA License # 1059
GA License # LPC004163
GA License # MSW006790
GA License # MSW006914
GA License # OT005584
GA License # PT002001
GA License # PT010499
GA License # SLP007882
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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