Healthcare Provider Details

I. General information

NPI: 1144605916
Provider Name (Legal Business Name): SENSATIONAL KIDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 07/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 S GREELEY HWY SUITE E
CHEYENNE WY
82007-3057
US

IV. Provider business mailing address

918 W BRUNDAGE LN
SHERIDAN WY
82801-5827
US

V. Phone/Fax

Practice location:
  • Phone: 307-634-2109
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHELLIE SZMYD
Title or Position: OWNER
Credential:
Phone: 307-673-4420