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General NPI Number Information
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NPI Number | 1861228025
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Entity Type | Organization
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Legal Business Name | SENSORY TREE PEDIATRIC THERAPY LLC
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Dates
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Enumeration Date | 09/12/2024
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 1036 DUNN AVE STE 4-175
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City | JACKSONVILLE
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State | FL
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Zip | 32218-6349
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Country | US
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Telephone | 904-479-5830
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Fax |
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Provider Business Mailing Address
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Address Line | 1036 DUNN AVE STE 4-175
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City | JACKSONVILLE
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State | FL
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Zip | 32218-6349
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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 | OCCUPATIONAL THERAPIST
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Name | BELGIUM LYNN MASOOD
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Credential | OTD, OTR/L
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Telephone | 904-479-5830
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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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