Provider Demographics
NPI:1811620032
Name:FUN TIME THERAPY LLC
Entity Type:Organization
Organization Name:FUN TIME THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-379-3043
Mailing Address - Street 1:569 ABBINGTON DR STE H
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-5800
Mailing Address - Country:US
Mailing Address - Phone:609-379-3043
Mailing Address - Fax:
Practice Address - Street 1:569 ABBINGTON DR
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-5800
Practice Address - Country:US
Practice Address - Phone:908-692-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2024-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ41YS00760400OtherASHA