Provider Demographics
NPI:1568289320
Name:BRADY KIDS THERAPY LLC
Entity type:Organization
Organization Name:BRADY KIDS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:DIAMELBA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARBONE
Authorized Official - Suffix:
Authorized Official - Credentials:SLPA
Authorized Official - Phone:786-447-3332
Mailing Address - Street 1:11521 SW 81ST TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3611
Mailing Address - Country:US
Mailing Address - Phone:786-447-3332
Mailing Address - Fax:
Practice Address - Street 1:11521 SW 81ST TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3611
Practice Address - Country:US
Practice Address - Phone:786-447-3332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty