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General NPI Number Information
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NPI Number | 1710489430
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Entity Type | Organization
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Legal Business Name | THERAPY OUT THE BOX, LLC
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 08/16/2018
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Provider Practice Location Address
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Address Line | 12251 TAFT ST STE 302
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City | PEMBROKE PINES
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State | FL
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Zip | 33026
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Country | US
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Telephone | 954-951-0974
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Fax | 954-743-1915
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Provider Business Mailing Address
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Address Line | 350 NW 134TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2251
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Country | US
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Telephone | 954-536-2319
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST/OWNER
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Name | LAINISHA MCMILLER TURNER
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Credential | OTR/L
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Telephone | 954-536-2319
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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 | 11795
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License Number State | FL
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