Thrive Pediatric Feeding Therapy Llc | |
4120 Bellemeade Ave Evansville IN 47714-0612 | |
(812) 470-6589 | |
Not Available |
Full Name | Thrive Pediatric Feeding Therapy Llc |
---|---|
Speciality | Psychologist - Clinical |
Location | 4120 Bellemeade Ave, Evansville, Indiana |
Authorized Official Name and Position | Elizabeth Page Clawson (OWNER) |
Authorized Official Contact | 8124706589 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Thrive Pediatric Feeding Therapy Llc 4120 Bellemeade Ave Evansville IN 47714-0612 Ph: (812) 470-6589 | Thrive Pediatric Feeding Therapy Llc 4120 Bellemeade Ave Evansville IN 47714-0612 Ph: (812) 470-6589 |
NPI Number | 1093201808 |
---|---|
Provider Enumeration Date | 07/04/2018 |
Last Update Date | 07/04/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093201808 | NPI | - | NPPES |
007710607 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 20042290A (Indiana) | Primary |
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