Organization
ALLWONDERBILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL VERISSIMO (CO-FOUNDER)
(843) 806-1858
Entity
Organization
Contact information
Practice address
3510 PARK AVENUE BLVD STE 105, MOUNT PLEASANT, SC 29466-7361
(843) 806-1858
(843) 326-0161
Mailing address
1504 FAITH ST, MOUNT PLEASANT, SC 29466-6874
(843) 806-1858
(843) 326-0161
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
224Z00000X
Occupational Therapy Assistant
—
—
2251P0200X
Pediatric Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
01/06/2025
Last updated
04/01/2025
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