Cirque Therapy, LLC

Organization Active NPI Pediatric Occupational Therapist · Homer, AK

NPI 1275937013 · NPPES record last updated Oct 21, 2014

Key facts

NPI
1275937013
Entity type
Organization (NPI type 2)
Primary specialty
Pediatric Occupational Therapist 225XP0200X
License
2854 (AK)
Legal business name
CIRQUE THERAPY, LLC
Practice address
653 W Fairview Ave
Apt I
Homer, AK 99603-7444
Phone
(907) 756-1101
NPI assigned
Oct 21, 2014
Organization subpart
No

Authorized official

Name
Melissa L Gagnon, OTD, OTR/L
Title
Member, Occupational Therapist
Phone
(907) 756-1101

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225XP0200X 2854 AK Yes

Addresses

Primary practice location

653 W Fairview Ave
Apt I
Homer, AK 99603-7444

Mailing address

PO Box 2157
Homer, AK 99603-2157
Phone (907) 756-1101

Other providers in Homer, AK

All providers in Homer, AK · Pediatric Occupational Therapist in Alaska

Sources for this page

Verify at the official NPI Registry.