Provider Demographics
NPI:1356110084
Name:MOTHERAPY4 INC
Entity type:Organization
Organization Name:MOTHERAPY4 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:DORIA SEGURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-487-3228
Mailing Address - Street 1:8652 NW 112TH CT
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-5609
Mailing Address - Country:US
Mailing Address - Phone:626-487-3228
Mailing Address - Fax:
Practice Address - Street 1:4180 SW 74TH CT STE 202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4443
Practice Address - Country:US
Practice Address - Phone:786-464-0369
Practice Address - Fax:786-332-2882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-21
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center