Provider Demographics
NPI:1417363540
Name:SENSORY IN MOTION THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:SENSORY IN MOTION THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSOTR/L
Authorized Official - Phone:251-680-3759
Mailing Address - Street 1:201 ATWATER AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-8200
Mailing Address - Country:US
Mailing Address - Phone:251-680-3759
Mailing Address - Fax:
Practice Address - Street 1:22873 US HIGHWAY 98
Practice Address - Street 2:BUILDING I, SUITE 1
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-6391
Practice Address - Country:US
Practice Address - Phone:251-680-3759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3562225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty