Over the Moon Pediatric Therapy Co
Over the Moon Pediatric Therapy Co is an Early Intervention Provider Agency in New Lenox, Illinois. Licensed in Illinois. Registered with an NPI since 2013.
- Licensed in
- IL
- In the registry since
- 2013
Practice location Address checks out
3308 Ivywild LnNew Lenox, IL 60451-9517
Phone: (815) 212-0536
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Early Intervention Provider Agency (primary) | Taxonomy 252Y00000X · Licence MV60460511P (IL) |
|---|
Record details
| NPI number | 1710308580 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Michele Valecek — Owner · (815) 212-0536 |
| NPI enumerated | December 21, 2013 |
| Last updated in NPPES | December 21, 2013 |
| Mailing address | 3308 Ivywild Ln, New Lenox, IL 60451-9517 |
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MS. Karen Marie Wingfield
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