Provider Demographics
NPI:1598929259
Name:KIDABILITIES, PA
Entity type:Organization
Organization Name:KIDABILITIES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHAREHOLDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:NAY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:252-916-5022
Mailing Address - Street 1:4077 HAMS WOODS LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-8206
Mailing Address - Country:US
Mailing Address - Phone:252-916-5022
Mailing Address - Fax:
Practice Address - Street 1:4077 HAMS WOODS LN
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-8206
Practice Address - Country:US
Practice Address - Phone:252-916-5022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3600225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty