Healthcare Provider Details
I. General information
NPI: 1891025490
Provider Name (Legal Business Name): THERAPY SPOT INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/04/2010
Last Update Date: 01/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7100 W. CAMINO REAL SUITE 201
BOCA RATON FL
33433-5510
US
IV. Provider business mailing address
7100 W. CAMINO REAL SUITE 201
BOCA RATON FL
33433-5510
US
V. Phone/Fax
- Phone: 561-859-2100
- Fax: 561-963-1623
- Phone: 561-859-2100
- Fax: 561-963-1623
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | FL |
VIII. Authorized Official
Name: MS.
MONICA
M.
WELLER
Title or Position: PEDIATRIC OCCUPATIONAL THERAPIST
Credential: M.S. OTR/L
Phone: 561-859-2100