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General NPI Number Information
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NPI Number | 1366995573
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Entity Type | Organization
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Legal Business Name | PLAY TO LEARN THERAPY, INC.
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Dates
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Enumeration Date | 07/25/2016
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Last Update Date | 07/25/2016
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Provider Practice Location Address
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Address Line | 10841 SW 128TH ST
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City | MIAMI
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State | FL
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Zip | 33176-5442
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Country | US
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Telephone | 786-553-1720
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 160591
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City | MIAMI
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State | FL
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Zip | 33116-0591
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MS. LORIN N HEAGAN
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Credential | MOT, OTR/L
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Telephone | 786-553-1720
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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 | OT15216
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License Number State | FL
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