Provider Demographics
NPI:1093404014
Name:PLAYFUL PATHWAYS THERAPY
Entity Type:Organization
Organization Name:PLAYFUL PATHWAYS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSPERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR/L
Authorized Official - Phone:320-292-2166
Mailing Address - Street 1:23747 FOOTHILLS DR
Mailing Address - Street 2:
Mailing Address - City:DEERWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:56444-6329
Mailing Address - Country:US
Mailing Address - Phone:320-292-2166
Mailing Address - Fax:
Practice Address - Street 1:604 OAK ST
Practice Address - Street 2:
Practice Address - City:CROSBY
Practice Address - State:MN
Practice Address - Zip Code:56441-1244
Practice Address - Country:US
Practice Address - Phone:320-292-2166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty