OrganizationActive
Kidspace Therapy, LLC
NPI 1184019184 · Developmental Disabilities Clinic/Center · Longview, WA
Provider details
- NPI number
- 1184019184
- Entity type
- Organization
- Primary specialty
- Developmental Disabilities Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Leslie Wolff, Owner(360) 560-1972
- License
- OT00001294 (WA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Practice location
2145 Tibbetts Dr Ste a
Longview, WA 98632-4211
Phone: (360) 560-1972
Fax: (360) 703-3452
Approximate (ZIP-level) locationGet directions
Mailing address
2145 Tibbetts Dr Ste a
Longview, WA 98632-4211
Registry dates
- Enumerated
- 2015-04-06
- Last updated
- 2020-07-15
- Certified
- 2020-07-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.