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General NPI Number Information
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NPI Number | 1679196117
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Entity Type | Organization
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Legal Business Name | SENSIPLAY PEDIATRIC THERAPY
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Dates
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Enumeration Date | 05/19/2020
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Last Update Date | 04/15/2023
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Provider Practice Location Address
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Address Line | 206 QUEEN ST STE 10
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City | VIDALIA
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State | GA
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Zip | 30474-4263
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Country | US
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Telephone | 912-537-3066
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2145
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City | VIDALIA
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State | GA
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Zip | 30475-2145
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Country | US
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Telephone | 912-537-3066
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Fax | 912-538-9812
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Authorized Official
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Title or Position | AGENT/MANAGER
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Name | LATOYA HARVEY
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Credential | OTD, OTR/L
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Telephone | 478-484-0049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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