Provider Demographics
NPI:1639627136
Name:KIDS THERAPY CORNER
Entity Type:Organization
Organization Name:KIDS THERAPY CORNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BILLIG
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:402-415-9435
Mailing Address - Street 1:2008 WEST BROADWAY
Mailing Address - Street 2:133
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501
Mailing Address - Country:US
Mailing Address - Phone:712-308-8233
Mailing Address - Fax:
Practice Address - Street 1:2008 W BROADWAY
Practice Address - Street 2:133
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-3763
Practice Address - Country:US
Practice Address - Phone:712-308-8233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty