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.

NPI 1053080382Madison, MSPediatric Occupational Therapist

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)

Browse Similar Providers

See more providers in the Occupational Therapist classification in Madison, MS.

Open Occupational Therapist providers in Madison, MS

Open the exact Pediatrics specialty directory in Madison, MS

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)