Provider Demographics
NPI:1215320080
Name:MOVING KIDS FORWARD THERAPY, LLC
Entity type:Organization
Organization Name:MOVING KIDS FORWARD THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:603-521-8434
Mailing Address - Street 1:547 AMHERST ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-4000
Mailing Address - Country:US
Mailing Address - Phone:603-521-8434
Mailing Address - Fax:603-864-8865
Practice Address - Street 1:547 AMHERST ST
Practice Address - Street 2:SUITE 204
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-4000
Practice Address - Country:US
Practice Address - Phone:603-521-8434
Practice Address - Fax:603-864-8865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1624174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty