Provider Demographics
NPI:1417272972
Name:MORE THAN PLAY PEDIATRIC THERAPY, LLC
Entity Type:Organization
Organization Name:MORE THAN PLAY PEDIATRIC THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:JOHNSON STUBER
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR/L
Authorized Official - Phone:614-327-0567
Mailing Address - Street 1:3615 S STATE ROUTE 605
Mailing Address - Street 2:SUITE B
Mailing Address - City:GALENA
Mailing Address - State:OH
Mailing Address - Zip Code:43021-9459
Mailing Address - Country:US
Mailing Address - Phone:614-327-0567
Mailing Address - Fax:614-895-2685
Practice Address - Street 1:3615 S STATE ROUTE 605
Practice Address - Street 2:SUITE B
Practice Address - City:GALENA
Practice Address - State:OH
Practice Address - Zip Code:43021-9459
Practice Address - Country:US
Practice Address - Phone:614-327-0567
Practice Address - Fax:614-895-2685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-28
Last Update Date:2010-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH005600225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty