Provider Demographics
NPI:1306085758
Name:BEYOND PLAY, LLC
Entity type:Organization
Organization Name:BEYOND PLAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEAGAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:228-217-7717
Mailing Address - Street 1:9117 OLD WALNUT RD
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-9590
Mailing Address - Country:US
Mailing Address - Phone:228-217-7717
Mailing Address - Fax:228-875-0767
Practice Address - Street 1:9117 OLD WALNUT RD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-9590
Practice Address - Country:US
Practice Address - Phone:228-217-7717
Practice Address - Fax:228-875-0767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT 1703225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty