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General NPI Number Information
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NPI Number | 1679334023
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Entity Type | Organization
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Legal Business Name | GROW PEDIATRIC THERAPY SERVICES
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 800 HIGHWAY 131
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City | WELLINGTON
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State | MO
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Zip | 64097-7119
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Country | US
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Telephone | 660-202-7107
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Fax |
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Provider Business Mailing Address
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Address Line | 30882 HIGHWAY NN
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City | BLACKBURN
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State | MO
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Zip | 65321-2007
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Country | US
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Telephone | 660-202-7107
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. DEVIN E GRAF
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Credential | OTR/L
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Telephone | 660-202-7107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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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