Provider Demographics
NPI:1689186355
Name:EAT PLAY LEARN THERAPIES
Entity Type:Organization
Organization Name:EAT PLAY LEARN THERAPIES
Other - Org Name:EAT PLAY LEARN THERAPIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:303-249-8185
Mailing Address - Street 1:862 SUMMER DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-3095
Mailing Address - Country:US
Mailing Address - Phone:303-249-8185
Mailing Address - Fax:
Practice Address - Street 1:862 SUMMER DR
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-3095
Practice Address - Country:US
Practice Address - Phone:303-249-8185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002583225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty