Healthcare Provider Details

I. General information

NPI: 1952853970
Provider Name (Legal Business Name): SENSAWEE PLAY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 11/18/2022
Certification Date: 11/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1816 BRIARWOOD INDUSTRIAL CT NE STE A
BROOKHAVEN GA
30329-1642
US

IV. Provider business mailing address

1816 BRIARWOOD INDUSTRIAL CT NE STE A
BROOKHAVEN GA
30329-1642
US

V. Phone/Fax

Practice location:
  • Phone: 404-636-5272
  • Fax: 404-636-5644
Mailing address:
  • Phone: 404-636-5272
  • Fax: 404-636-5644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberGAOT2642
License Number StateGA

VIII. Authorized Official

Name: MRS. FLORIE GLUSMAN
Title or Position: OWNER, THERAPIST
Credential: OTR/L
Phone: 404-636-5272