Provider Demographics
NPI:1154567345
Name:BIG SKY PEDIATRIC THERAPY
Entity type:Organization
Organization Name:BIG SKY PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CAREN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:OTD OTR OWNER
Authorized Official - Phone:512-306-8007
Mailing Address - Street 1:9433 BEE CAVE RD
Mailing Address - Street 2:B3 STE 101
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78733
Mailing Address - Country:US
Mailing Address - Phone:512-306-8007
Mailing Address - Fax:512-672-6178
Practice Address - Street 1:9433 BEE CAVE RD
Practice Address - Street 2:B3 STE 101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78733
Practice Address - Country:US
Practice Address - Phone:512-306-8007
Practice Address - Fax:512-672-6178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty