Provider Demographics
NPI:1407006232
Name:SENSATIONAL OCCUPATIONAL THERAPY,LLC
Entity Type:Organization
Organization Name:SENSATIONAL OCCUPATIONAL THERAPY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:AUGUST
Authorized Official - Suffix:
Authorized Official - Credentials:MS OTR/L
Authorized Official - Phone:904-557-8972
Mailing Address - Street 1:4829 INNISBROOK CT S
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:FL
Mailing Address - Zip Code:32033-2067
Mailing Address - Country:US
Mailing Address - Phone:904-557-8972
Mailing Address - Fax:
Practice Address - Street 1:4829 INNISBROOK CT S
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:FL
Practice Address - Zip Code:32033-2067
Practice Address - Country:US
Practice Address - Phone:904-557-8972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12817225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty