Provider Demographics
NPI:1043553639
Name:AT PLAY OCCUPATIONAL THERAPY SERVICES, INC
Entity Type:Organization
Organization Name:AT PLAY OCCUPATIONAL THERAPY SERVICES, INC
Other - Org Name:AT PLAY; AT PLAY OT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JONTUE
Authorized Official - Middle Name:L
Authorized Official - Last Name:KOFF
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:808-381-0625
Mailing Address - Street 1:1227 SUN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1645
Mailing Address - Country:US
Mailing Address - Phone:808-381-0625
Mailing Address - Fax:
Practice Address - Street 1:1227 SUN VALLEY RD
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1645
Practice Address - Country:US
Practice Address - Phone:808-381-0625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11294225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty