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General NPI Number Information
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NPI Number | 1952074007
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Entity Type | Organization
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Legal Business Name | THERAPEDZ THERAPIST UNLIMITED, LLC
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Dates
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Enumeration Date | 07/26/2021
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Last Update Date | 02/19/2022
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Provider Practice Location Address
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Address Line | 14574 DURBIN ISLAND WAY
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City | ST JOHNS
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State | FL
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Zip | 32259-7094
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Country | US
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Telephone | 904-200-2712
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Fax |
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Provider Business Mailing Address
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Address Line | 14574 DURBIN ISLAND WAY
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City | ST JOHNS
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State | FL
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Zip | 32259-7094
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Country | US
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Telephone | 904-200-2712
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RHONDA MITCHELL
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Credential | OCCUPATIONAL THERAPY
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Telephone | 904-200-2712
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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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