Healthcare Provider Details

I. General information

NPI: 1184180697
Provider Name (Legal Business Name): OT4LIFE OCCUPATIONAL THERAPY FOR CHILDREN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2019
Last Update Date: 02/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18794 POINT CYPRESS COURT
BOCA RATON FL
33498-6344
US

IV. Provider business mailing address

18794 POINT CYPRESS COURT
BOCA RATON FL
33498-6344
US

V. Phone/Fax

Practice location:
  • Phone: 561-419-3944
  • Fax:
Mailing address:
  • Phone: 561-419-3944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: HEIDI DAKIN
Title or Position: PRESIDENT/OCCUPATIONAL THERAPIST
Credential: MOT, OTR/L
Phone: 561-419-3944