Organization
KIDS THERAPY PLACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONAH KALEIAHI MAWAE DPT (CO-OWNER)
(253) 686-2094
Entity
Organization
Contact information
Practice address
1225 TRIUMPH CT, LAS VEGAS, NV 89117-7122
(248) 930-2554
Mailing address
1225 TRIUMPH CT, LAS VEGAS, NV 89117-7122
(248) 930-2554
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/19/2021
Last updated
11/19/2021
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