Provider Demographics
NPI:1386253128
Name:PLAY LEARN LIVE THERAPY INC
Entity type:Organization
Organization Name:PLAY LEARN LIVE THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:J
Authorized Official - Last Name:BURCH
Authorized Official - Suffix:
Authorized Official - Credentials:MSOT
Authorized Official - Phone:334-740-1756
Mailing Address - Street 1:2613 TIMOTHY RD
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-1036
Mailing Address - Country:US
Mailing Address - Phone:334-740-1756
Mailing Address - Fax:
Practice Address - Street 1:545 W MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-1626
Practice Address - Country:US
Practice Address - Phone:334-740-1756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty