Provider Demographics
NPI:1871097279
Name:LIVE AND LEARN THERAPY, LLC
Entity type:Organization
Organization Name:LIVE AND LEARN THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:FABIOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONILLE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:954-634-2354
Mailing Address - Street 1:3016 S OAKLAND FOREST DR APT 2906
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-5610
Mailing Address - Country:US
Mailing Address - Phone:954-634-2354
Mailing Address - Fax:954-206-0919
Practice Address - Street 1:3016 S OAKLAND FOREST DR APT 2906
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-5610
Practice Address - Country:US
Practice Address - Phone:954-634-2354
Practice Address - Fax:954-206-0919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2022-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT15033225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty