Organization
IMAGINATION THERAPY PLLC
Active
Organization
IMAGINATION THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUNITA MURTY-GAMI MS OTRL ITFS (MANAGER OCCUPATIONAL THERAPIST)
(314) 749-9654
Entity
Organization
Contact information
Practice address
1179 HARP ST, RALEIGH, NC 27604-1303
(919) 324-1881
(919) 324-1781
Mailing address
1179 HARP ST, RALEIGH, NC 27604-1303
(919) 324-1881
(919) 324-1781
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
5739
NC
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019W4
BCBS
NC
05
—
7200132
—
NC
Enumeration date
12/10/2007
Last updated
11/10/2011
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