Provider Demographics
NPI:1386776763
Name:GROWING PLACES THERAPY SERVICES, PLLC
Entity type:Organization
Organization Name:GROWING PLACES THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:512-587-5671
Mailing Address - Street 1:2100 WESTFALIAN TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-1967
Mailing Address - Country:US
Mailing Address - Phone:512-587-5671
Mailing Address - Fax:512-535-6786
Practice Address - Street 1:2100 WESTFALIAN TRL
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-1967
Practice Address - Country:US
Practice Address - Phone:512-587-5671
Practice Address - Fax:512-535-6786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1118164225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty