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General NPI Number Information
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NPI Number | 1477851004
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Entity Type | Organization
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Legal Business Name | THERAPLAY, LTD.
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Dates
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Enumeration Date | 03/07/2011
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Last Update Date | 03/07/2011
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Provider Practice Location Address
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Address Line | 1 E SCOTT ST #604
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City | CHICAGO
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State | IL
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Zip | 60610-2372
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Country | US
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Telephone | 312-848-4201
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Fax |
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Provider Business Mailing Address
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Address Line | 1 E SCOTT ST #604
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City | CHICAGO
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State | IL
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Zip | 60610-2372
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Country | US
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Telephone | 312-848-4201
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. SHARI BURGGRAF LENZ
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Credential | MOTR/L
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Telephone | 312-848-4201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 056004923
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License Number State | IL
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