# PLAYFUL MINDS PEDIATRIC THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811745144
- **Authorized official:** KAYLA NICHOLS OTR/L (CEO/ OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (770) 362-6079

## Contact information

- **Practice address:** 11373 OAK ALLEY DR S, GRAND BAY, AL 36541-4489
- **Practice address phone:** (770) 362-6079
- **Practice address fax:** (251) 252-0367
- **Mailing address:** 11373 OAK ALLEY DR S, GRAND BAY, AL 36541-4489
- **Mailing address phone:** (770) 362-6079
- **Mailing address fax:** (251) 252-0367

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | — | NULL | Yes |
| 225X00000X | Occupational Therapist | — | — | Yes |

## Other

- **Enumeration date:** 05/10/2024
- **Last updated:** 05/10/2024