National Provider Identifier
Dandelion Pediatric Therapy, LLC
Dandelion Pediatric Therapy, LLC is listed in the NPPES registry with a primary specialty of Pediatric Occupational Therapist in Madison, MS and a listed phone number of (601) 826-2609.
Source: public NPPES record, last updated September 09, 2021. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.
Profile Overview
- NPI
- 1053080382
- Provider Type
- Organization
- Primary Specialty
- Pediatric Occupational Therapist
- Enumeration Date
- September 09, 2021
- Last Updated
- September 09, 2021
Practice Location
- 125 Stillhouse Creek Dr
- Madison, MS 39110-6943
Phone: (601) 826-2609
Mailing Address
- PO Box 415
- Madison, MS 39130-0415
Authorized Official
- Name
- Mrs. Ashley Nicole Buck
- Title
- Sole Member
- Credentials
- MS, OTR/L
- Phone
- (601) 826-2609
Specialties
- Pediatric Occupational Therapist (225XP0200X)
- Occupational Therapist (225X00000X)
- Occupational Therapy Assistant (224Z00000X)
- Pediatric Physical Therapist (2251P0200X)
- Physical Therapy Assistant (225200000X)
- Speech-Language Assistant (2355S0801X)
- Speech-Language Pathologist (235Z00000X)
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Full Record
- NPI
- 1053080382
- Entity Type
- Organization
- Organization Name
- Dandelion Pediatric Therapy, LLC
- Mailing Street Address
- PO Box 415
- Mailing City
- Madison
- Mailing State
- MS
- Mailing ZIP Code
- 39130-0415
- Mailing Country
- US
- Mailing Phone
- (601) 826-2609
- Practice Street Address
- 125 Stillhouse Creek Dr
- Practice City
- Madison
- Practice State
- MS
- Practice ZIP Code
- 39110-6943
- Practice Country
- US
- Practice Phone
- (601) 826-2609
- Enumeration Date
- September 09, 2021
- Last Updated
- September 09, 2021
- Authorized Official Last Name
- Buck
- Authorized Official First Name
- Ashley
- Authorized Official Middle Name
- Nicole
- Authorized Official Title
- Sole Member
- Authorized Official Phone
- (601) 826-2609
- Organization Subpart
- No
- Authorized Official Name Prefix Text
- Mrs.
- Authorized Official Credential Text
- MS, OTR/L
- Taxonomy Group 1
- 193200000X Multi-Specialty Group
- Taxonomy Group 2
- 193200000X Multi-Specialty Group
- Taxonomy Group 3
- 193200000X Multi-Specialty Group
- Taxonomy Group 4
- 193200000X Multi-Specialty Group
- Taxonomy Group 5
- 193200000X Multi-Specialty Group
- Taxonomy Group 6
- 193200000X Multi-Specialty Group
- Taxonomy Group 7
- 193200000X Multi-Specialty Group
- Certification Date
- September 09, 2021
- Taxonomies
- Pediatric Occupational Therapist (225XP0200X), Occupational Therapist (225X00000X), Occupational Therapy Assistant (224Z00000X), Pediatric Physical Therapist (2251P0200X), Physical Therapy Assistant (225200000X), Speech-Language Assistant (2355S0801X), Speech-Language Pathologist (235Z00000X)