Provider Demographics
NPI:1811077977
Name:CHILDREN'S THERAPY WORKS, INC
Entity type:Organization
Organization Name:CHILDREN'S THERAPY WORKS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:DANIELSON KRIPPNER
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:320-420-4080
Mailing Address - Street 1:312 4TH ST SW STE 11
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-3332
Mailing Address - Country:US
Mailing Address - Phone:320-214-7082
Mailing Address - Fax:320-235-8059
Practice Address - Street 1:2653 COUNTY ROAD 74
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-2205
Practice Address - Country:US
Practice Address - Phone:320-229-4069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN379363235Z00000X
MN102487225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN412M2CHOtherBC/BS BUSINESS