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General NPI Number Information
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NPI Number | 1437547551
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Entity Type | Organization
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Legal Business Name | PLAY2GROW PEDIATRIC THERAPY, INC.
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Dates
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Enumeration Date | 12/23/2014
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Last Update Date | 12/23/2014
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Provider Practice Location Address
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Address Line | 6768 9TH AVE
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City | SACRAMENTO
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State | CA
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Zip | 95820-2106
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Country | US
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Telephone | 916-834-4379
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Fax |
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Provider Business Mailing Address
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Address Line | 5714 FOLSOM BLVD PLAY2GROW PEDIATRIC THERAPY #297
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City | SACRAMENTO
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State | CA
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Zip | 95819-4608
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Country | US
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Telephone | 916-834-4379
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | REBECCA O'CALLAGHAN
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Credential | M.S., OTR/L, SWC
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Telephone | 916-834-4379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapist
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License Number | OT 7936
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT 7936
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License Number State | CA
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