Organization
PEDIATRIC PLAY THERAPY, LLC
Active
Other names
Pediatric Play Therapy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VALERIE CHARMAINE BELLGRANTHAM (CEO)
(919) 736-8580
Entity
Organization
Contact information
Practice address
1709 TOMMYS RD, GOLDSBORO, NC 27534-7991
(919) 736-8580
Mailing address
1709 TOMMYS RD, GOLDSBORO, NC 27534-7991
(919) 736-8580
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300049
—
NC
Enumeration date
02/05/2007
Last updated
07/31/2008
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