Organization
SUNSHINE THERAPY CLUB II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TARAYA J. SHIRDAN LPT, M.ED. (DIRECTOR)
(610) 853-9919
Entity
Organization
Contact information
Practice address
410 W TOWNSHIP LINE RD, SUITE 4, HAVERTOWN, PA 19083-5237
(610) 853-9919
(610) 853-9921
Mailing address
410 W TOWNSHIP LINE RD, SUITE 4, HAVERTOWN, PA 19083-5237
(610) 853-9919
(610) 853-9921
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
PA
252Y00000X
Early Intervention Provider Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008092540006
—
PA
Enumeration date
12/06/2007
Last updated
04/13/2016
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