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General NPI Number Information
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NPI Number | 1508389644
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Entity Type | Organization
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Legal Business Name | KONFETTI KIDZ THERAPY
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Dates
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Enumeration Date | 07/20/2017
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | 17901 NW 5TH ST STE 201
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City | PEMBROKE PINES
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State | FL
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Zip | 33029
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Country | US
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Telephone | 954-606-5439
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Fax |
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Provider Business Mailing Address
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Address Line | 17901 NW 5TH ST STE 201
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-2810
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Country | US
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Telephone | 954-606-5439
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MELISSA MANRESA
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Credential | MS, OTR/L
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Telephone | 954-606-5439
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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