Healthcare Provider Details

I. General information

NPI: 1982233284
Provider Name (Legal Business Name): ILOVE CHILDREN THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 04/07/2020
Certification Date: 04/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7233 GOLF COLONY CT APT 202
LAKE WORTH FL
33467-3987
US

IV. Provider business mailing address

7233 GOLF COLONY CT APT 202
LAKE WORTH FL
33467-3987
US

V. Phone/Fax

Practice location:
  • Phone: 786-612-1141
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SAMARY SULLIVAN
Title or Position: OWNER
Credential:
Phone: 786-612-1141