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General NPI Number Information
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NPI Number | 1275731242
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Entity Type | Organization
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Legal Business Name | OT 4 KIDZ, INC
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 06/14/2010
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Provider Practice Location Address
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Address Line | 1932 14TH ST UNIT B
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City | SANTA MONICA
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State | CA
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Zip | 90404-7028
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Country | US
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Telephone | 310-344-2276
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Fax |
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Provider Business Mailing Address
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Address Line | 1932 14TH ST UNIT B
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City | SANTA MONICA
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State | CA
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Zip | 90404-4605
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Country | US
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Telephone | 310-344-2276
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC OCCUPATIONAL THERAPIST
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Name | KARI THOMPSON
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Credential | OTD, OTR/L, BCP
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Telephone | 310-344-2276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 2077
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License Number State | CA
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