Provider Demographics
NPI:1851605604
Name:SENSATIONAL KIDS, LLC
Entity Type:Organization
Organization Name:SENSATIONAL KIDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SZMYD
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:307-673-4420
Mailing Address - Street 1:520 S BROOKS ST
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-4707
Mailing Address - Country:US
Mailing Address - Phone:307-673-4420
Mailing Address - Fax:307-673-4420
Practice Address - Street 1:727 E BRUNDAGE LN STE E
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-6280
Practice Address - Country:US
Practice Address - Phone:307-673-4420
Practice Address - Fax:307-673-4420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYOTR-787225XP0200X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty