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General NPI Number Information
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NPI Number | 1952853970
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Entity Type | Organization
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Legal Business Name | SENSAWEE PLAY
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 1816 BRIARWOOD INDUSTRIAL CT NE STE A
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City | BROOKHAVEN
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State | GA
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Zip | 30329-1642
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Country | US
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Telephone | 404-636-5272
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Fax | 404-636-5644
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Provider Business Mailing Address
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Address Line | 1816 BRIARWOOD INDUSTRIAL CT NE STE A
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City | BROOKHAVEN
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State | GA
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Zip | 30329-1642
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Country | US
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Telephone | 404-636-5272
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Fax | 404-636-5644
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | MRS. FLORIE GLUSMAN
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Credential | OTR/L
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Telephone | 404-636-5272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | GAOT2642
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License Number State | GA
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