Provider Demographics
| NPI: | 1508636150 |
|---|---|
| Name: | FEEL PLAY GROW |
| Entity Type: | Organization |
| Organization Name: | FEEL PLAY GROW |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OCCUPATIONAL THERAPIST |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | MARK |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | HOLADAY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | OTR/L |
| Authorized Official - Phone: | 720-435-4341 |
| Mailing Address - Street 1: | 1895 BLUFF ST APT A |
| Mailing Address - Street 2: | |
| Mailing Address - City: | BOULDER |
| Mailing Address - State: | CO |
| Mailing Address - Zip Code: | 80304-4286 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 720-435-4341 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 1895 BLUFF ST APT A |
| Practice Address - Street 2: | |
| Practice Address - City: | BOULDER |
| Practice Address - State: | CO |
| Practice Address - Zip Code: | 80304-4286 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 720-435-4341 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2024-01-04 |
| Last Update Date: | 2024-01-25 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 225XE0001X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Environmental Modification | Group - Multi-Specialty |
| No | 225XF0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Feeding, Eating & Swallowing | Group - Multi-Specialty |
| No | 225XH1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Human Factors | Group - Multi-Specialty |
| No | 225XM0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Mental Health | Group - Multi-Specialty |
| No | 225XN1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Neurorehabilitation | Group - Multi-Specialty |
| No | 225XP0019X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation | Group - Multi-Specialty |
| No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
