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General NPI Number Information
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NPI Number | 1629984331
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Entity Type | Organization
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Legal Business Name | GROWTH SPURT PEDIATRIC THERAPY, INC.
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Dates
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Enumeration Date | 08/21/2026
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Last Update Date | 08/21/2026
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Provider Practice Location Address
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Address Line | 5554 THOMAS RD
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City | SEBASTOPOL
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State | CA
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Zip | 95472-9377
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Country | US
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Telephone | 415-297-8892
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Fax |
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Provider Business Mailing Address
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Address Line | 5554 THOMAS RD
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City | SEBASTOPOL
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State | CA
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Zip | 95472-9377
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Country | US
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Telephone | 415-297-8892
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. ANYA SOLED
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Credential | OTR/L
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Telephone | 415-297-8892
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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 | 225XF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapist
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License Number |
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License Number State |
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