Provider Demographics
NPI:1710664800
Name:AVIDITY OCCUPATIONAL THERAPY INC.
Entity Type:Organization
Organization Name:AVIDITY OCCUPATIONAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:O'MEA-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:619-821-4555
Mailing Address - Street 1:1901 1ST AVE # 228
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-2356
Mailing Address - Country:US
Mailing Address - Phone:858-522-9121
Mailing Address - Fax:
Practice Address - Street 1:1901 1ST AVE # 228
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-2356
Practice Address - Country:US
Practice Address - Phone:858-522-9121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-29
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty