Organization
GO PLAY THERAPY, L.L.C.
Active
Other names
Go Play Therapy Center, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SILVIA HERNANDEZ (OWNER / MANAGER)
(256) 979-1222
Entity
Organization
Contact information
Practice address
2804 GREENHILL BLVD NW STE 102, FORT PAYNE, AL 35968-3067
(256) 979-1222
(256) 979-1223
Mailing address
2804 GREENHILL BLVD NW STE 102, FORT PAYNE, AL 35968-3067
(256) 979-1222
(256) 979-1223
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212348
—
AL
Enumeration date
02/05/2018
Last updated
11/27/2018
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