Provider Demographics
NPI:1982933966
Name:BREAKING BOUNDARIES OCCUPATIONAL THERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:BREAKING BOUNDARIES OCCUPATIONAL THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:MS/OTR/L
Authorized Official - Phone:585-295-3953
Mailing Address - Street 1:8 MERCHANTS RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-7852
Mailing Address - Country:US
Mailing Address - Phone:585-295-3953
Mailing Address - Fax:585-413-0119
Practice Address - Street 1:8 MERCHANTS RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-7852
Practice Address - Country:US
Practice Address - Phone:585-295-3953
Practice Address - Fax:585-413-0119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-21
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011585-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency