Organization
SKY BRIDGE THERAPIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA BONILLA MOTR/L (OCCUPATIONAL THERAPY DEPT. HEAD)
(253) 201-1234
Entity
Organization
Contact information
Practice address
9307 BRIDGEPORT WAY SW, LAKEWOOD, WA 98499-1570
(516) 510-5963
Mailing address
9124 GRAVELLY LAKE DR SW STE 102, LAKEWOOD, WA 98499-3198
(253) 201-1234
(253) 235-4201
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
Other
Enumeration date
11/26/2017
Last updated
03/18/2021
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