Provider Demographics
NPI:1982331146
Name:PURPOSEFUL PLAY PEDIATRIC THERAPIES LLC
Entity Type:Organization
Organization Name:PURPOSEFUL PLAY PEDIATRIC THERAPIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEGEN
Authorized Official - Middle Name:ANNE BLAESING
Authorized Official - Last Name:BRUMMETT
Authorized Official - Suffix:
Authorized Official - Credentials:MSOT, OTR/L
Authorized Official - Phone:434-941-8185
Mailing Address - Street 1:2839 BISHOP CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LYNCH STATION
Mailing Address - State:VA
Mailing Address - Zip Code:24571-2445
Mailing Address - Country:US
Mailing Address - Phone:434-941-8185
Mailing Address - Fax:
Practice Address - Street 1:2839 BISHOP CREEK RD
Practice Address - Street 2:
Practice Address - City:LYNCH STATION
Practice Address - State:VA
Practice Address - Zip Code:24571-2445
Practice Address - Country:US
Practice Address - Phone:434-941-8185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-06
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty