Healthcare Provider Details
I. General information
NPI: 1629911805
Provider Name (Legal Business Name): BUBBLES & BEAMS PEDIATRIC THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6350 RED CEDAR PL UNIT 307
BALTIMORE MD
21209-5405
US
IV. Provider business mailing address
6350 RED CEDAR PL UNIT 307
BALTIMORE MD
21209-5405
US
V. Phone/Fax
- Phone: 313-720-7213
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHOSHANA
SOSKIL
Title or Position: OWNER
Credential: OTR/L
Phone: 313-720-7213