Provider Demographics
NPI:1386288348
Name:LITTLE RASCALS OCCUPATIONAL THERAPY, LLC
Entity type:Organization
Organization Name:LITTLE RASCALS OCCUPATIONAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROSCHAT
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:360-441-0596
Mailing Address - Street 1:914 CITADEL DR STE F
Mailing Address - Street 2:
Mailing Address - City:EVERSON
Mailing Address - State:WA
Mailing Address - Zip Code:98247-9668
Mailing Address - Country:US
Mailing Address - Phone:360-441-0596
Mailing Address - Fax:
Practice Address - Street 1:914 CITADEL DR STE F
Practice Address - Street 2:
Practice Address - City:EVERSON
Practice Address - State:WA
Practice Address - Zip Code:98247-9668
Practice Address - Country:US
Practice Address - Phone:360-441-0596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-03
Last Update Date:2019-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty