Organization
EAT PLAY GROW OT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLA KIM (OWNER/OCCUPATIONAL THERAPIST)
(207) 312-8437
Entity
Organization
Contact information
Practice address
120 CENTER ST STE 109, AUBURN, ME 04210-6339
(207) 312-8437
Mailing address
188 EAST AVE, LEWISTON, ME 04240-5515
(207) 312-8437
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467087379
—
ME
Enumeration date
01/31/2024
Last updated
01/31/2024
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