Provider Demographics
NPI:1861003725
Name:AMAZING ACHIEVEMENTS OCCUPATIONAL THERAPY, PLLC
Entity Type:Organization
Organization Name:AMAZING ACHIEVEMENTS OCCUPATIONAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:708-712-1200
Mailing Address - Street 1:22 TIMBER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-1667
Mailing Address - Country:US
Mailing Address - Phone:708-712-1200
Mailing Address - Fax:
Practice Address - Street 1:174 MORGAN RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:CT
Practice Address - Zip Code:06019-2034
Practice Address - Country:US
Practice Address - Phone:708-712-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation