Healthcare Provider Details

I. General information

NPI: 1487419610
Provider Name (Legal Business Name): PLAY ON WORDS THERAPY CONNECTIONS OF NC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2024
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 LAUREL RDG
FRANKLIN NC
28734-5707
US

IV. Provider business mailing address

96 LAUREL RDG
FRANKLIN NC
28734-5707
US

V. Phone/Fax

Practice location:
  • Phone: 941-587-4919
  • Fax:
Mailing address:
  • Phone: 941-587-4919
  • 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 Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. TARA CORTOPASSI
Title or Position: EXECUTIVE DIRECTOR
Credential: BCBA
Phone: 941-587-4919