Provider Demographics
NPI:1992232524
Name:PLAY AND GROW THERAPY INC
Entity type:Organization
Organization Name:PLAY AND GROW THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RAEJEAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:561-450-9576
Mailing Address - Street 1:455 NE 5TH AVE STE D330
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5658
Mailing Address - Country:US
Mailing Address - Phone:561-450-9576
Mailing Address - Fax:
Practice Address - Street 1:455 NE 5TH AVE STE D330
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5658
Practice Address - Country:US
Practice Address - Phone:561-450-9576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT18453225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty