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General NPI Number Information
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NPI Number | 1881605400
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Entity Type | Organization
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Legal Business Name | WALK & PLAY THERAPY, INC.
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17572 W BRIDLE TRAIL RD
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City | GURNEE
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State | IL
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Zip | 60031-1649
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Country | US
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Telephone | 847-263-1516
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Fax | 847-263-1516
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Provider Business Mailing Address
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Address Line | 17572 W BRIDLE TRAIL RD
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City | GURNEE
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State | IL
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Zip | 60031-1649
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Country | US
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Telephone | 847-263-1516
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Fax | 847-263-1516
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Authorized Official
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Title or Position | PRESIDENT
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Name | FEHMIDA MOHAMED HABIB VALIULLAH
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Credential | PT
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Telephone | 847-263-1516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State | IL
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