Provider Demographics
| NPI: | 1144808718 |
|---|---|
| Name: | SENSORY WELLNESS LLC |
| Entity type: | Organization |
| Organization Name: | SENSORY WELLNESS LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER/OCCUPATIONAL THERAPIST |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | LENIA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | GOFF |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | OTR/L |
| Authorized Official - Phone: | 913-548-6598 |
| Mailing Address - Street 1: | 1940 PAVILION DR APT 111 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | VIRGINIA BEACH |
| Mailing Address - State: | VA |
| Mailing Address - Zip Code: | 23451-5583 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 913-548-6598 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 1940 PAVILION DR APT 111 |
| Practice Address - Street 2: | |
| Practice Address - City: | VIRGINIA BEACH |
| Practice Address - State: | VA |
| Practice Address - Zip Code: | 23451-5583 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 913-548-6598 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2021-04-01 |
| Last Update Date: | 2021-04-01 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Single Specialty |