Organization
BOOST KIDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEA A BESHARA OT (OWNER/OT)
(225) 241-4435
Entity
Organization
Contact information
Practice address
1623 2ND AVE N STE F, BIRMINGHAM, AL 35203-1918
(225) 241-4435
Mailing address
1623 2ND AVE N STE F, BIRMINGHAM, AL 35203-1918
(225) 241-4435
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
10/23/2017
Last updated
10/23/2017
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