Provider Demographics
NPI:1346987872
Name:PICKLETREES LLC
Entity Type:Organization
Organization Name:PICKLETREES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:PETROSKI
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L
Authorized Official - Phone:302-363-8136
Mailing Address - Street 1:103 SPRINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-9658
Mailing Address - Country:US
Mailing Address - Phone:302-363-8136
Mailing Address - Fax:
Practice Address - Street 1:103 SPRINGWOOD DR
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-9658
Practice Address - Country:US
Practice Address - Phone:302-363-8136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-17
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty