Provider Demographics
NPI:1104411297
Name:DKD FOR AUTISM LLC
Entity type:Organization
Organization Name:DKD FOR AUTISM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR /OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARRI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOJAEI-SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-722-3892
Mailing Address - Street 1:410 HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:FATE
Mailing Address - State:TX
Mailing Address - Zip Code:75087-6709
Mailing Address - Country:US
Mailing Address - Phone:972-722-3892
Mailing Address - Fax:214-602-2729
Practice Address - Street 1:601 N WILLIAM E CRAWFORD AVE
Practice Address - Street 2:
Practice Address - City:FATE
Practice Address - State:TX
Practice Address - Zip Code:75087
Practice Address - Country:US
Practice Address - Phone:469-338-5442
Practice Address - Fax:214-602-2729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty