Organization
SENSIPLAY PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATOYA HARVEY OTD, OTR/L (AGENT/MANAGER)
(478) 484-0049
Entity
Organization
Contact information
Practice address
206 QUEEN ST STE 10, VIDALIA, GA 30474-4263
(912) 537-3066
Mailing address
PO BOX 2145, VIDALIA, GA 30475-2145
(912) 537-3066
(912) 538-9812
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003173099C
—
GA
05
—
003233426B
—
GA
Enumeration date
05/19/2020
Last updated
04/15/2023
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