Provider Demographics
NPI:1588390777
Name:CHILDS PLAY THERAPY TEAM, LLC
Entity type:Organization
Organization Name:CHILDS PLAY THERAPY TEAM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:L
Authorized Official - Last Name:WELBORN-MABREY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, PCS
Authorized Official - Phone:812-449-2740
Mailing Address - Street 1:10600 W SEVEN HILLS RD
Mailing Address - Street 2:
Mailing Address - City:ELBERFELD
Mailing Address - State:IN
Mailing Address - Zip Code:47613-9468
Mailing Address - Country:US
Mailing Address - Phone:812-449-2740
Mailing Address - Fax:812-615-5123
Practice Address - Street 1:400 S 3RD AVE
Practice Address - Street 2:
Practice Address - City:HAUBSTADT
Practice Address - State:IN
Practice Address - Zip Code:47639-8225
Practice Address - Country:US
Practice Address - Phone:812-449-2740
Practice Address - Fax:812-615-5123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty