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

Mini Miracles Pediatric Therapy, PLLC

Organization Developmentally Disabled Services Day Training Agency · NPI 1477991560

Mini Miracles Pediatric Therapy, PLLC is a Developmentally Disabled Services Day Training Agency in Johnson City, Tennessee. Licensed in Virginia. Registered with an NPI since 2013.

Licensed in
VA
In the registry since
2013
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

2214 E Fairview Ave
Johnson City, TN 37601-2860
Phone: (423) 928-6464
Fax: (423) 232-7970
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Early Intervention Provider Agency (primary) Taxonomy 252Y00000X · Licence 4611 (VA)
Developmentally Disabled Services Day Training Agency Taxonomy 251C00000X · Licence 0119003962 (VA)

Record details

NPI number1477991560
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Douglas Brown — Ceo/Owner · (601) 624-1237
NPI enumeratedJune 11, 2013
Last updated in NPPESOctober 3, 2023
Certification dateOctober 3, 2023
Mailing addressPo Box 191, Johnson City, TN 37605-0191

Other providers in Johnson City