Provider Demographics
NPI:1659836831
Name:SENSORY KIDS WILTON
Entity Type:Organization
Organization Name:SENSORY KIDS WILTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MS OTR/L
Authorized Official - Phone:203-422-2193
Mailing Address - Street 1:78 HARVARD AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-5548
Mailing Address - Country:US
Mailing Address - Phone:203-422-2193
Mailing Address - Fax:
Practice Address - Street 1:78 HARVARD AVE STE 220
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-5548
Practice Address - Country:US
Practice Address - Phone:203-422-2193
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SENSORY KIDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty