Organization
PEDIATRIC PLAY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUE M HENRY OT #1899 (PRESIDENT)
(408) 218-4136
Entity
Organization
Contact information
Practice address
2109 OTOOLE AVE STE M, SAN JOSE, CA 95131-1338
(408) 573-7720
Mailing address
2109 OTOOLE AVE STE M, SAN JOSE, CA 95131-1338
(408) 573-7720
Taxonomy
Speciality
Code
Description
License number
State
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
08/19/2025
Last updated
08/28/2025
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