Provider Demographics
NPI:1982483525
Name:THRIVE KIDS THERAPY LLC
Entity Type:Organization
Organization Name:THRIVE KIDS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KAITLYN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SOTTILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-609-7833
Mailing Address - Street 1:135 HOLLIS LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-3612
Mailing Address - Country:US
Mailing Address - Phone:919-609-7833
Mailing Address - Fax:
Practice Address - Street 1:135 HOLLIS LN
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28409-3612
Practice Address - Country:US
Practice Address - Phone:919-609-7833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty