Provider Demographics
NPI:1316391337
Name:WORK IS PLAY
Entity Type:Organization
Organization Name:WORK IS PLAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATION THERAPY SOLE PROPRIETOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOND
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTRL
Authorized Official - Phone:502-650-4120
Mailing Address - Street 1:2400 WINDSOR FOREST DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40272-2334
Mailing Address - Country:US
Mailing Address - Phone:502-650-4120
Mailing Address - Fax:502-416-1204
Practice Address - Street 1:2400 WINDSOR FOREST DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-2334
Practice Address - Country:US
Practice Address - Phone:502-650-4120
Practice Address - Fax:502-416-1204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-15
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR3450273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit