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General NPI Number Information
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NPI Number | 1518112416
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Entity Type | Organization
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Legal Business Name | SENSATIONAL KIDS THERAPY, PLLC
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Dates
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Enumeration Date | 11/20/2008
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Last Update Date | 07/08/2013
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Provider Practice Location Address
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Address Line | 2245 PLANTATION CENTER DR. STE. 57
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-3352
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Country | US
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Telephone | 904-374-1414
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Fax | 877-736-3470
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Provider Business Mailing Address
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Address Line | 4829 INNISBROOK CT S
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City | ELKTON
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State | FL
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Zip | 32033-2067
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Country | US
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Telephone | 904-374-1414
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Fax | 877-736-3470
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | AMANDA J AUGUST
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Credential | MS OTR/L
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Telephone | 904-374-1414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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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 | 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 #3
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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