Provider Demographics
NPI: | 1972118453 |
---|---|
Name: | THERAPEUTIC LEARNING,LLC |
Entity type: | Organization |
Organization Name: | THERAPEUTIC LEARNING,LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | MICHELLE |
Authorized Official - Middle Name: | S |
Authorized Official - Last Name: | ROSENBERG |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | BA COTA |
Authorized Official - Phone: | 954-536-2322 |
Mailing Address - Street 1: | 2674 OAK PARK CIR |
Mailing Address - Street 2: | |
Mailing Address - City: | DAVIE |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33328-6722 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 954-536-2322 |
Mailing Address - Fax: | 954-329-0007 |
Practice Address - Street 1: | 2674 OAK PARK CIR |
Practice Address - Street 2: | |
Practice Address - City: | DAVIE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33328-6722 |
Practice Address - Country: | US |
Practice Address - Phone: | 954-536-2322 |
Practice Address - Fax: | 954-329-0007 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-09-11 |
Last Update Date: | 2020-09-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Single Specialty |