Provider Demographics
NPI:1760165765
Name:RAY OF SUNSHINE PEDIATRIC THERAPY, LLC
Entity Type:Organization
Organization Name:RAY OF SUNSHINE PEDIATRIC THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L
Authorized Official - Phone:479-719-7255
Mailing Address - Street 1:7415 W HIGHWAY 10
Mailing Address - Street 2:
Mailing Address - City:HACKETT
Mailing Address - State:AR
Mailing Address - Zip Code:72937-4574
Mailing Address - Country:US
Mailing Address - Phone:479-719-7255
Mailing Address - Fax:
Practice Address - Street 1:7415 W HIGHWAY 10
Practice Address - Street 2:
Practice Address - City:HACKETT
Practice Address - State:AR
Practice Address - Zip Code:72937-4574
Practice Address - Country:US
Practice Address - Phone:479-719-7255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty