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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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