Provider Demographics
NPI:1871834069
Name:MADE2MOVE: THERAPY4KIDS, PLLC
Entity Type:Organization
Organization Name:MADE2MOVE: THERAPY4KIDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OT
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LETSOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-254-5541
Mailing Address - Street 1:11343 N SAM HOUSTON PKWY E
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-4598
Mailing Address - Country:US
Mailing Address - Phone:713-254-5541
Mailing Address - Fax:281-441-9081
Practice Address - Street 1:4142 VALLEY HAVEN DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1953
Practice Address - Country:US
Practice Address - Phone:713-254-5541
Practice Address - Fax:281-441-9081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104786174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty