Provider Demographics
NPI:1295128197
Name:O.W.L. ACADEMY, LMSW, SLP, PT & OT LLP
Entity type:Organization
Organization Name:O.W.L. ACADEMY, LMSW, SLP, PT & OT LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORLOV
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:917-968-5560
Mailing Address - Street 1:1689 GLENMORE AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-2828
Mailing Address - Country:US
Mailing Address - Phone:917-968-5560
Mailing Address - Fax:
Practice Address - Street 1:1689 GLENMORE AVE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2828
Practice Address - Country:US
Practice Address - Phone:917-968-5560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY112384252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency