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General NPI Number Information
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NPI Number | 1598151326
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Entity Type | Organization
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Legal Business Name | KIDSENSE THERAPY GROUP, LLC
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 09/08/2015
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Provider Practice Location Address
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Address Line | 209 CHERRY ST
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City | MILFORD
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State | CT
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Zip | 06460-3501
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Country | US
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Telephone | 203-874-5437
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Fax | 203-301-0552
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Provider Business Mailing Address
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Address Line | 209 CHERRY ST
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City | MILFORD
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State | CT
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Zip | 06460-3501
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Country | US
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Telephone | 203-874-5437
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA GRIFFITH
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Credential | COTA/L
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Telephone | 203-874-5437
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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 |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 008591
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number |
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License Number State |
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