Provider Demographics
NPI:1093573065
Name:PLAYTIME SOLUTIONS DEVELOPMENTAL THERAPY, PLLC
Entity Type:Organization
Organization Name:PLAYTIME SOLUTIONS DEVELOPMENTAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:DYSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-222-6639
Mailing Address - Street 1:3425 OAK GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-1856
Mailing Address - Country:US
Mailing Address - Phone:815-222-6639
Mailing Address - Fax:
Practice Address - Street 1:3425 OAK GROVE AVE
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-1856
Practice Address - Country:US
Practice Address - Phone:815-222-6639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency