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General NPI Number Information
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NPI Number | 1710545561
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Entity Type | Organization
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Legal Business Name | YOUNGSTERS OCCUPATIONAL THERAPY, LLC
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Dates
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Enumeration Date | 06/05/2019
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Last Update Date | 09/29/2024
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Provider Practice Location Address
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Address Line | 780 ASTURIAS RD
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City | DAVENPORT
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State | FL
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Zip | 33837-3862
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Country | US
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Telephone | 239-259-1992
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1937
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City | DAVENPORT
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State | FL
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Zip | 33836-1937
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | ASHLEY YOUNG
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Credential |
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Telephone | 239-259-1992
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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 |
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License Number State |
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