Provider Demographics
NPI:1316689375
Name:WONDER BABY THERAPY, LLC
Entity type:Organization
Organization Name:WONDER BABY THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:DESANTIS
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR/L
Authorized Official - Phone:484-269-6812
Mailing Address - Street 1:4 BLACK LATCH LN
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1404
Mailing Address - Country:US
Mailing Address - Phone:484-269-6812
Mailing Address - Fax:
Practice Address - Street 1:4 BLACK LATCH LN
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1404
Practice Address - Country:US
Practice Address - Phone:484-269-6812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty