=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891025490
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THERAPY SPOT INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/04/2010
-----------------------------------------------------
Last Update Date | 01/04/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7100 W. CAMINO REAL SUITE 201
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33433-5510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-859-2100
-----------------------------------------------------
Fax | 561-963-1623
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7100 W. CAMINO REAL SUITE 201
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33433-5510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-859-2100
-----------------------------------------------------
Fax | 561-963-1623
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PEDIATRIC OCCUPATIONAL THERAPIST
-----------------------------------------------------
Name | MS. MONICA M. WELLER
-----------------------------------------------------
Credential | M.S. OTR/L
-----------------------------------------------------
Telephone | 561-859-2100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------