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General NPI Number Information
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NPI Number | 1215635164
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Entity Type | Organization
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Legal Business Name | PAVING WAYS THERAPEUTIC SERVICES INC.
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 4311 SW 160TH AVE APT 201
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City | MIRAMAR
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State | FL
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Zip | 33027-5761
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Country | US
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Telephone | 786-216-5453
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Fax |
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Provider Business Mailing Address
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Address Line | 4311 SW 160TH AVE APT 201
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City | MIRAMAR
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State | FL
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Zip | 33027-5761
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Country | US
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Telephone | 786-216-5453
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST/ PRESIDENT
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Name | MRS. ALEXA NICHOLE LAVERNIA
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Credential | M.S., OTR/L
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Telephone | 786-216-5453
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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 |
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License Number State |
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