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General NPI Number Information
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NPI Number | 1366913527
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Entity Type | Organization
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Legal Business Name | SENSORY OUTLET THERAPY
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Dates
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Enumeration Date | 12/16/2018
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Last Update Date | 12/16/2018
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Provider Practice Location Address
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Address Line | 7 BRIDGEWOOD AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4749
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Country | US
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Telephone | 732-776-7078
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Fax |
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Provider Business Mailing Address
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Address Line | 7 BRIDGEWOOD AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4749
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Country | US
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Telephone | 732-776-7078
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | AARON SAKS
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Credential |
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Telephone | 570-815-2829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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