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Organization

SKILLZ 4 LIFE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARLEETA HARRIS OTR/L (PRESIDENT/ OCCUPATIONAL THERAPIST)
(502) 855-1271
Entity
Organization

Contact information

Practice address
3814 GREENWICH RD, LOUISVILLE, KY 40218-1616
(502) 855-1271
Mailing address
3814 GREENWICH RD, LOUISVILLE, KY 40218-1616
(502) 855-1271

Taxonomy

Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
2251P0200X
Pediatric Physical Therapist
225XP0200X
Pediatric Occupational Therapist
Primary
R5089
KY
235Z00000X
Speech-Language Pathologist

Other

Enumeration date
06/13/2016
Last updated
06/13/2016
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