Provider Demographics
NPI:1497801906
Name:TINY TOTS THERAPY
Entity Type:Organization
Organization Name:TINY TOTS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRANSTETTER
Authorized Official - Suffix:
Authorized Official - Credentials:MOTRL
Authorized Official - Phone:816-739-4346
Mailing Address - Street 1:3213 NE 59TH TER
Mailing Address - Street 2:APT 4
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64119-2163
Mailing Address - Country:US
Mailing Address - Phone:816-739-4346
Mailing Address - Fax:
Practice Address - Street 1:3213 NE 59TH TER
Practice Address - Street 2:APT 4
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64119-2163
Practice Address - Country:US
Practice Address - Phone:816-739-4346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001015184251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health