Organization
HIGH FIVE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAISON METROCK (OWNER)
(954) 554-1633
Entity
Organization
Contact information
Practice address
1674 NW 143RD WAY, PEMBROKE PINES, FL 33028-3009
(954) 554-1633
Mailing address
1674 NW 143RD WAY, PEMBROKE PINES, FL 33028-3009
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003582700
—
FL
Enumeration date
05/22/2014
Last updated
07/22/2016
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