Provider Demographics
NPI:1679196117
Name:SENSIPLAY PEDIATRIC THERAPY
Entity Type:Organization
Organization Name:SENSIPLAY PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L
Authorized Official - Phone:478-484-0049
Mailing Address - Street 1:PO BOX 2145
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30475-2145
Mailing Address - Country:US
Mailing Address - Phone:912-537-3066
Mailing Address - Fax:912-538-9812
Practice Address - Street 1:206 QUEEN ST STE 10
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474-4263
Practice Address - Country:US
Practice Address - Phone:912-537-3066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2023-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003233426BMedicaid
GA003173099CMedicaid