Healthcare Provider Details

I. General information

NPI: 1639789639
Provider Name (Legal Business Name): DEVELOPMENTOOLS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2020
Last Update Date: 09/23/2020
Certification Date: 09/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3285 SEBASTIAN LN
LEXINGTON KY
40513-1240
US

IV. Provider business mailing address

3285 SEBASTIAN LN
LEXINGTON KY
40513-1240
US

V. Phone/Fax

Practice location:
  • Phone: 904-716-1233
  • Fax:
Mailing address:
  • Phone: 904-716-1233
  • Fax:

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 Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. ALISON SIMS
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTD, OTR/L
Phone: 904-716-1233