Provider Demographics
NPI:1144605916
Name:SENSATIONAL KIDS LLC
Entity type:Organization
Organization Name:SENSATIONAL KIDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SZMYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-673-4420
Mailing Address - Street 1:918 W BRUNDAGE LN
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-5827
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:903 S GREELEY HWY
Practice Address - Street 2:SUITE E
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82007-3057
Practice Address - Country:US
Practice Address - Phone:307-634-2109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty