Provider Demographics
NPI:1548556921
Name:OCCUPATIONAL THERAPY SERVICES FOR KIDS
Entity type:Organization
Organization Name:OCCUPATIONAL THERAPY SERVICES FOR KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROSSI
Authorized Official - Suffix:
Authorized Official - Credentials:MOT, OTR
Authorized Official - Phone:219-746-1650
Mailing Address - Street 1:11095 WHITCOMB ST
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-3603
Mailing Address - Country:US
Mailing Address - Phone:219-746-1650
Mailing Address - Fax:219-663-3977
Practice Address - Street 1:11095 WHITCOMB ST
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-3603
Practice Address - Country:US
Practice Address - Phone:219-746-1650
Practice Address - Fax:219-663-3977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004163A225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty