Provider Demographics
NPI:1891028114
Name:OT 4 KIDS, INC.
Entity Type:Organization
Organization Name:OT 4 KIDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:PULKET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-447-4699
Mailing Address - Street 1:1125 PATRICK HENRY DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3517
Mailing Address - Country:US
Mailing Address - Phone:703-237-7320
Mailing Address - Fax:
Practice Address - Street 1:1125 PATRICK HENRY DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3517
Practice Address - Country:US
Practice Address - Phone:703-237-7320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-18
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty