Healthcare Provider Details

I. General information

NPI: 1003452582
Provider Name (Legal Business Name): NORTH NAPLES THERAPY & ENRICHMENT SERVICES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2019
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 PINE RIDGE RD STE 120
NAPLES FL
34109-2116
US

IV. Provider business mailing address

1421 PINE RIDGE RD STE 120
NAPLES FL
34109-2116
US

V. Phone/Fax

Practice location:
  • Phone: 239-597-0935
  • Fax: 239-597-0031
Mailing address:
  • Phone: 239-597-0935
  • Fax: 239-597-0031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATHRYN MITCHELL
Title or Position: PRESIDENT
Credential: MS, OTR/L
Phone: 239-597-0935