MEDICARE: PLAY 2 LEARN LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	2251P0200X	Pediatric Physical Therapist
2	235Z00000X	Speech-Language Pathologist
3	225XP0200X	Pediatric Occupational Therapist

General Provider Information

NPI Number	:	1871154930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLAY 2 LEARN LLC

Provider Business Mailing Address
First Line	:	347 BRUNSWICK
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-1988
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15048 SAN PEDRO AVE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-3714
Country	:	US
Telephone Number	:	512-827-3670
Fax Number	:	512-777-5042

Authorized Official
Title or Position	:	DIRECTOR OF THERAPY
Name	:	JOANNA VERDONE
Credential	:
Telephone Number	:	512-827-3670

Provider Enumeration Date	:	06/27/2019
Last Update Date	:	06/27/2019

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Directions to “PLAY 2 LEARN LLC ” Practice Location

Language	Start Address	Practice Location

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