Provider Demographics
NPI:1437639010
Name:KIDS AT WORK OCCUPATIONAL THERAPY, INC.
Entity Type:Organization
Organization Name:KIDS AT WORK OCCUPATIONAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAUNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KRZANOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:561-315-9726
Mailing Address - Street 1:8441 BOWIE WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-1176
Mailing Address - Country:US
Mailing Address - Phone:561-315-9726
Mailing Address - Fax:561-967-3837
Practice Address - Street 1:8441 BOWIE WAY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-1176
Practice Address - Country:US
Practice Address - Phone:561-315-9726
Practice Address - Fax:561-967-3837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT2306225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL880307200Medicaid