=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689976110
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE SENSORY CONNECTION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2010
-----------------------------------------------------
Last Update Date | 12/05/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6743 E BROADWAY BLVD
-----------------------------------------------------
City | TUCSON
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85710-2806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-298-5437
-----------------------------------------------------
Fax | 520-298-5438
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6743 E BROADWAY BLVD
-----------------------------------------------------
City | TUCSON
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85710-2806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-298-5437
-----------------------------------------------------
Fax | 520-298-5438
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/THERAPIST
-----------------------------------------------------
Name | MS. CHERYL DUMEY PLATT
-----------------------------------------------------
Credential | OTR
-----------------------------------------------------
Telephone | 520-298-5437
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR0400X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Clinic/Center
-----------------------------------------------------
License Number | 2373
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------