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General NPI Number Information
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NPI Number | 1689970485
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Entity Type | Organization
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Legal Business Name | FAMILIES FIRST OCCUPATIONAL THERAPY
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Dates
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Enumeration Date | 01/27/2011
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Last Update Date | 01/27/2011
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Provider Practice Location Address
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Address Line | 621 17TH ST
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City | PACIFIC GROVE
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State | CA
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Zip | 93950-4211
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Country | US
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Telephone | 443-404-1234
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 52141
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City | PACIFIC GROVE
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State | CA
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Zip | 93950-7141
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Country | US
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Telephone | 443-404-1234
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MS. WHITNEY L. DAWSON
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Credential |
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Telephone | 443-404-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 10461646
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 03889
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 9426
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License Number State | CA
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