Healthcare Provider Details

I. General information

NPI: 1073167649
Provider Name (Legal Business Name): MOVE & PLAY THERAPY FOR CHILDREN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2019
Last Update Date: 07/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9520 STATELINE RD
NORTH EAST PA
16428-5411
US

IV. Provider business mailing address

9520 STATELINE RD
NORTH EAST PA
16428-5411
US

V. Phone/Fax

Practice location:
  • Phone: 814-746-9548
  • Fax:
Mailing address:
  • Phone: 814-746-9548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. EMILY ANN ASPDEN
Title or Position: OWNER, PHYSICAL THERAPIST
Credential: MPT
Phone: 814-746-9548