Organization
KIDSHINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY C WHEADON MS, OTR/L (OWNER)
(781) 367-9729
Entity
Organization
Contact information
Practice address
75 TURNPIKE RD # 3C, IPSWICH, MA 01938-1046
(978) 356-0315
(978) 356-0316
Mailing address
75 TURNPIKE RD # 3C, IPSWICH, MA 01938-1046
(978) 356-0315
(978) 356-0316
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
7585
MA
Other
Enumeration date
11/12/2015
Last updated
05/15/2019
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