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General NPI Number Information
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NPI Number | 1326215203
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Entity Type | Organization
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Legal Business Name | KID SENSE, PA
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Dates
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Enumeration Date | 05/10/2008
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Last Update Date | 05/10/2008
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Provider Practice Location Address
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Address Line | 3161 HIGHWAY 334
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City | PONTOTOC
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State | MS
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Zip | 38863-6160
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Country | US
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Telephone | 662-308-0145
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Fax |
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Provider Business Mailing Address
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Address Line | 3161 HIGHWAY 334
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City | PONTOTOC
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State | MS
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Zip | 38863-6160
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Country | US
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Telephone | 662-308-0145
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARCIA L WASHINGTON
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Credential | OTR/L
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Telephone | 662-308-0145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | OT1226
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License Number State | MS
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