Provider Demographics
NPI:1538919725
Name:PLAY MOVE GROW OCCUPATIONAL THERAPY PLLC
Entity type:Organization
Organization Name:PLAY MOVE GROW OCCUPATIONAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:518-646-6662
Mailing Address - Street 1:125 HIGH ROCK AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-2307
Mailing Address - Country:US
Mailing Address - Phone:518-646-6662
Mailing Address - Fax:
Practice Address - Street 1:125 HIGH ROCK AVE STE 208
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2307
Practice Address - Country:US
Practice Address - Phone:518-646-6662
Practice Address - Fax:518-430-5855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty