Provider Demographics
NPI:1134792187
Name:CONFIDENT KIDS THERAPY, LLC
Entity type:Organization
Organization Name:CONFIDENT KIDS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CALLI
Authorized Official - Middle Name:JO
Authorized Official - Last Name:STUDEBAKER
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L
Authorized Official - Phone:937-765-1811
Mailing Address - Street 1:510 COBBLESTONE DR
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-4328
Mailing Address - Country:US
Mailing Address - Phone:937-765-1811
Mailing Address - Fax:
Practice Address - Street 1:510 COBBLESTONE DR
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-4328
Practice Address - Country:US
Practice Address - Phone:937-765-1811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty