Provider Demographics
NPI:1184313041
Name:LETS PLAY PEDIATRIC THERAPY LLC
Entity type:Organization
Organization Name:LETS PLAY PEDIATRIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:JEWEL
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:706-348-5383
Mailing Address - Street 1:490 BARNETT SHOALS RD APT 546
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-7649
Mailing Address - Country:US
Mailing Address - Phone:706-348-5383
Mailing Address - Fax:
Practice Address - Street 1:490 BARNETT SHOALS RD APT 546
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-7649
Practice Address - Country:US
Practice Address - Phone:706-348-5383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty