Healthcare Provider Details

I. General information

NPI: 1467898320
Provider Name (Legal Business Name): PLAY TO LEARN OT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2013
Last Update Date: 05/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

572 TENNEY MOUNTAIN HWY
PLYMOUTH NH
03264-3145
US

IV. Provider business mailing address

572 TENNEY MOUNTAIN HWY
PLYMOUTH NH
03264-3145
US

V. Phone/Fax

Practice location:
  • Phone: 603-560-6127
  • Fax:
Mailing address:
  • Phone: 603-560-6127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number1286
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License Number1286
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number1286
License Number StateNH
# 4
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number1286
License Number StateNH
# 5
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number1286
License Number StateNH
# 6
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1286
License Number StateNH

VIII. Authorized Official

Name: FAITH OLARSCH
Title or Position: MEMBER
Credential: MS, OTR/L CPAM
Phone: 603-560-6127