Provider Demographics
NPI:1730704883
Name:THE MAMA AND BABY MOBILITY PROJECT
Entity type:Organization
Organization Name:THE MAMA AND BABY MOBILITY PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:ZANE
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:360-922-4458
Mailing Address - Street 1:2510 164TH ST SW APT E107
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-7836
Mailing Address - Country:US
Mailing Address - Phone:360-922-4458
Mailing Address - Fax:425-582-0846
Practice Address - Street 1:2510 164TH ST SW APT E107
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-7836
Practice Address - Country:US
Practice Address - Phone:360-922-4458
Practice Address - Fax:425-582-0846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty