Provider Demographics
NPI:1144486317
Name:THERAPY 4 KIDS INC
Entity type:Organization
Organization Name:THERAPY 4 KIDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:B
Authorized Official - Last Name:GODFREY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:918-806-1492
Mailing Address - Street 1:5110 S YALE AVE
Mailing Address - Street 2:STE 103
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-7401
Mailing Address - Country:US
Mailing Address - Phone:918-492-2386
Mailing Address - Fax:918-645-8686
Practice Address - Street 1:5110 S YALE AVE
Practice Address - Street 2:STE 103
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-7401
Practice Address - Country:US
Practice Address - Phone:918-492-2386
Practice Address - Fax:918-645-8686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-06
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
OK1464225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty