Healthcare Provider Details

I. General information

NPI: 1245142926
Provider Name (Legal Business Name): HARBOR KIDS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 RIVERPOINT DR
WEDOWEE AL
36278-7276
US

IV. Provider business mailing address

301 RIVERPOINT DR
WEDOWEE AL
36278-7276
US

V. Phone/Fax

Practice location:
  • Phone: 256-914-9696
  • Fax:
Mailing address:
  • Phone: 256-914-9696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY MILLER
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 256-914-9696