Provider Demographics
NPI:1811591837
Name:ANCHOR & ARROW THERAPY AND WELLNESS FOR KIDS
Entity Type:Organization
Organization Name:ANCHOR & ARROW THERAPY AND WELLNESS FOR KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:DEANN
Authorized Official - Last Name:LEY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:937-689-9296
Mailing Address - Street 1:400 BECK DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45458-4520
Mailing Address - Country:US
Mailing Address - Phone:937-689-9296
Mailing Address - Fax:
Practice Address - Street 1:5600 KENTSHIRE DR STE 206
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45440-2989
Practice Address - Country:US
Practice Address - Phone:937-365-7070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty