# KIDSHINE LLC

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

## Provider details

- **NPI number:** 1831562891
- **Authorized official:** MS. AMY C WHEADON MS, OTR/L (OWNER)
- **Authorized official phone:** (781) 367-9729

## Contact information

- **Practice address:** 75 TURNPIKE RD \# 3C, IPSWICH, MA 01938-1046
- **Practice address phone:** (978) 356-0315
- **Practice address fax:** (978) 356-0316
- **Mailing address:** 75 TURNPIKE RD \# 3C, IPSWICH, MA 01938-1046
- **Mailing address phone:** (978) 356-0315
- **Mailing address fax:** (978) 356-0316

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 261QD1600X | Developmental Disabilities Clinic/Center | 7585 | MA | Yes |

## Other

- **Enumeration date:** 11/12/2015
- **Last updated:** 05/15/2019