Healthcare Provider Details

I. General information

NPI: 1366255978
Provider Name (Legal Business Name): LITTLE PINEAPPLES PLAY THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

297 SEVEN FARMS DR STE 304
DANIEL ISLAND SC
29492-8721
US

IV. Provider business mailing address

297 SEVEN FARMS DR STE 304
DANIEL ISLAND SC
29492-8721
US

V. Phone/Fax

Practice location:
  • Phone: 854-276-8570
  • Fax:
Mailing address:
  • Phone: 854-276-8570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. ALEXA GERHAM
Title or Position: OWNER/ PEDIATRIC OT
Credential: MS, OTR/L
Phone: 854-276-8570