Provider Demographics
NPI: | 1871995209 |
---|---|
Name: | JLM THERAPY, INC. |
Entity type: | Organization |
Organization Name: | JLM THERAPY, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JULIE |
Authorized Official - Middle Name: | LYNN |
Authorized Official - Last Name: | MCGEE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OTR/L |
Authorized Official - Phone: | 239-207-4301 |
Mailing Address - Street 1: | 845 109TH AVE N |
Mailing Address - Street 2: | |
Mailing Address - City: | NAPLES |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 34108-1813 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 845 109TH AVE N |
Practice Address - Street 2: | |
Practice Address - City: | NAPLES |
Practice Address - State: | FL |
Practice Address - Zip Code: | 34108-1813 |
Practice Address - Country: | US |
Practice Address - Phone: | 239-207-4301 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-09-17 |
Last Update Date: | 2014-09-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | OT 10768 | 225X00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Single Specialty |