Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Black's Pediatric Therapy, Inc

Organization Pediatric Occupational Therapist · NPI 1477754067

Black's Pediatric Therapy, Inc is a Pediatric Occupational Therapist in Gainesville, Georgia. Licensed in Georgia. Registered with an NPI since 2007.

Licensed in
GA
In the registry since
2007
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4502 Summer Gate Ct
Gainesville, GA 30506
Phone: (770) 378-5986
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Occupational Therapist (primary) Taxonomy 225XP0200X · Licence 003199 (GA)

Record details

NPI number1477754067
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tina Black — Owner · (770) 378-5986
NPI enumeratedMay 30, 2007
Last updated in NPPESAugust 22, 2020
Mailing address4502 Summer Gate Ct., Gainesville, GA 30506

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