Provider Demographics
NPI:1427305143
Name:CDT KIDS
Entity type:Organization
Organization Name:CDT KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-265-5557
Mailing Address - Street 1:3324 E RAY RD UNIT 340
Mailing Address - Street 2:
Mailing Address - City:HIGLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85236-4516
Mailing Address - Country:US
Mailing Address - Phone:480-265-5557
Mailing Address - Fax:
Practice Address - Street 1:3324 E RAY RD UNIT 340
Practice Address - Street 2:
Practice Address - City:HIGLEY
Practice Address - State:AZ
Practice Address - Zip Code:85236-4516
Practice Address - Country:US
Practice Address - Phone:480-265-5557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-13
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 225X00000X, 235Z00000X, 261QP2000X, 261QX0100X
AZSLPA70192355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational MedicineGroup - Multi-Specialty