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General NPI Number Information
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NPI Number | 1629869615
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Entity Type | Organization
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Legal Business Name | SWEET PEA OT PLLC
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 1714 W LE MOYNE ST APT 1W
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City | CHICAGO
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State | IL
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Zip | 60622-2498
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Country | US
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Telephone | 248-935-4346
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Fax |
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Provider Business Mailing Address
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Address Line | 1714 W LE MOYNE ST APT 1W
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City | CHICAGO
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State | IL
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Zip | 60622-2498
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CLAIRE HUSAYNU
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Credential | MSOT, OTR/L
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Telephone | 248-935-4346
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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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