Healthcare Provider Details

I. General information

NPI: 1215698113
Provider Name (Legal Business Name): HANDS ON PLAY PEDIATRIC THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2022
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1590 BEAUMONT RD
ROANOKE VA
24019-5405
US

IV. Provider business mailing address

1590 BEAUMONT RD
ROANOKE VA
24019-5405
US

V. Phone/Fax

Practice location:
  • Phone: 540-251-1888
  • Fax:
Mailing address:
  • Phone: 540-251-1888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALLIE NEWTON
Title or Position: OWNER, OCCUPATIONAL THERAPIST
Credential: MS,OTR/L
Phone: 540-251-1888