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General NPI Number Information
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NPI Number | 1487967758
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Entity Type | Organization
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Legal Business Name | SENSORY SOLUTIONS SARASOTA
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Dates
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Enumeration Date | 07/15/2010
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Last Update Date | 07/15/2010
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Provider Practice Location Address
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Address Line | 5045 FRUITVILLE ROAD SUITE 145
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City | SARASOTA
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State | FL
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Zip | 34232
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Country | US
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Telephone | 941-400-4222
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Fax |
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Provider Business Mailing Address
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Address Line | 7005 SCRUB JAY WAY
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City | BRADENTON
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State | FL
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Zip | 34203
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Country | US
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Telephone | 941-400-4222
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR/OWNER
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Name | JENNIFER TIFFANY KIELLACH
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Credential | OTR/L
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Telephone | 941-400-4222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT 9946
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License Number State | FL
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