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General NPI Number Information
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NPI Number | 1336598085
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Entity Type | Organization
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Legal Business Name | LEAPS AND BOUNDS THERAPY CENTER, LLC
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Dates
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Enumeration Date | 06/03/2016
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Last Update Date | 06/03/2016
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Provider Practice Location Address
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Address Line | 1212 GERMANTOWN PIKE SUITE 3B
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462
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Country | US
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Telephone | 484-685-6606
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Fax |
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Provider Business Mailing Address
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Address Line | 1649 LARCHWOOD DR
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City | BLUE BELL
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State | PA
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Zip | 19422-3437
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Country | US
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Telephone | 484-685-6606
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Fax |
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Authorized Official
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Title or Position | OWNER, OCCUPATIONAL THERAPIST
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Name | MELISSA BROWN
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Credential | MOT, OTR/L
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Telephone | 484-685-6606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OC010240
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License Number State | PA
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