Provider Demographics
NPI:1194417154
Name:MADE FOR MOTHERHOOD LLC
Entity type:Organization
Organization Name:MADE FOR MOTHERHOOD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIACOMA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:480-375-8717
Mailing Address - Street 1:9057 W BLUE SAGUARO ST
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85653-1424
Mailing Address - Country:US
Mailing Address - Phone:480-375-8717
Mailing Address - Fax:
Practice Address - Street 1:9057 W BLUE SAGUARO ST
Practice Address - Street 2:
Practice Address - City:MARANA
Practice Address - State:AZ
Practice Address - Zip Code:85653-1424
Practice Address - Country:US
Practice Address - Phone:480-375-8717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty