Provider Demographics
NPI:1346520798
Name:OT WORKS 4 KIDZ, LLC
Entity Type:Organization
Organization Name:OT WORKS 4 KIDZ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:STAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MS,OTR/L
Authorized Official - Phone:603-870-0078
Mailing Address - Street 1:27 ROULSTON RD
Mailing Address - Street 2:UNIT 1
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1210
Mailing Address - Country:US
Mailing Address - Phone:603-870-0078
Mailing Address - Fax:603-870-8134
Practice Address - Street 1:27 ROULSTON RD
Practice Address - Street 2:UNIT 1
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-1210
Practice Address - Country:US
Practice Address - Phone:603-870-0078
Practice Address - Fax:603-870-8134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty