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Organization

MIRACLE KIDS LLC

Active
Other names
LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MS. RABINDER KAUR ROY OTRL (OWNER)
(678) 799-3599
Entity
Organization

Contact information

Practice address
1442 DRESDEN DR NE UNIT C258, BROOKHAVEN, GA 30319-3590
(678) 779-3599
(678) 922-1235
Mailing address
1442 DRESDEN DR NE UNIT C258, BROOKHAVEN, GA 30319-3590
(678) 779-3599
(678) 922-1235

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT002706
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000874849B
GA
Enumeration date
05/16/2007
Last updated
03/03/2017
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  • Eligibility checks
  • EDI platform