Provider Demographics
NPI:1619345824
Name:KID WORKS OCCUPATIONAL THERAPY LLC
Entity Type:Organization
Organization Name:KID WORKS OCCUPATIONAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ILGEN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:843-991-2694
Mailing Address - Street 1:1152 WELLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-4846
Mailing Address - Country:US
Mailing Address - Phone:843-991-2694
Mailing Address - Fax:843-405-1316
Practice Address - Street 1:1595 SAVANNAH HWY
Practice Address - Street 2:STE 3
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7820
Practice Address - Country:US
Practice Address - Phone:843-991-2694
Practice Address - Fax:843-405-1316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty