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General NPI Number Information
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NPI Number | 1215371612
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Entity Type | Organization
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Legal Business Name | LET'S PLAY PEDIATRIC THERAPY SERVICES, PLLC
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Dates
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Enumeration Date | 04/29/2013
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Last Update Date | 04/29/2013
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Provider Practice Location Address
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Address Line | 6304 KIT CREEK RD
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City | MORRISVILLE
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State | NC
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Zip | 27560-9353
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Country | US
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Telephone | 518-542-1027
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Fax | 919-544-5514
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Provider Business Mailing Address
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Address Line | 6304 KIT CREEK RD
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City | MORRISVILLE
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State | NC
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Zip | 27560-9353
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Country | US
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Telephone | 518-542-1027
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Fax | 919-544-5514
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Authorized Official
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Title or Position | OWNER
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Name | SHANNON FLYNN
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Credential | OTR/L
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Telephone | 518-542-1027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 4928
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License Number State | NC
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