MEDICARE: SENSATIONAL BEGINNINGS OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist

General Provider Information

NPI Number	:	1174284053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENSATIONAL BEGINNINGS OT

Provider Business Mailing Address
First Line	:	1789 BETHLEHEM RD NE
Second Line	:
City	:	NEW SALISBURY
State	:	IN
Zip	:	47161-7908
Country	:	US
Telephone Number	:	812-987-8744
Fax Number	:

Provider Business Practice Location Address
First Line	:	1789 BETHLEHEM RD NE
Second Line	:
City	:	NEW SALISBURY
State	:	IN
Zip	:	47161-7908
Country	:	US
Telephone Number	:	812-987-8744
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	MRS. SOSHANNA ANNAJEAN RENFRO
Credential	:	OTR/L
Telephone Number	:	812-987-8744

Provider Enumeration Date	:	01/04/2022
Last Update Date	:	01/04/2022

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Directions to “SENSATIONAL BEGINNINGS OT ” Practice Location

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