| Organization Name: | PEDIATRIC THERAPY GROUP LLC |
| NPI Number: | 1053586685 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CANDICE MOREE GRAY (OWNER) |
| Mailing Address: | 1034 Elizabeth Dr Baton Rouge |
| State: | LA US |
| Postal Code: | 708154509 |
| Phone Number: | 2259217216 |
| Fax Number: | 2259274059 |
| NPI Enumeration Date: | 04/24/2008 |
| NPI Last Update Date: | 02/17/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 4906 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |