Provider Demographics
NPI:1932853330
Name:RIVER'S BEND OCCUPATIONAL THERAPY, LLC
Entity Type:Organization
Organization Name:RIVER'S BEND OCCUPATIONAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:WRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR/L
Authorized Official - Phone:302-270-9154
Mailing Address - Street 1:102 REDBIRD DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-2656
Mailing Address - Country:US
Mailing Address - Phone:302-270-9154
Mailing Address - Fax:877-736-7647
Practice Address - Street 1:102 REDBIRD DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-2656
Practice Address - Country:US
Practice Address - Phone:302-270-9154
Practice Address - Fax:877-736-7647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-05
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty