Healthcare Provider Details

I. General information

NPI: 1811077977
Provider Name (Legal Business Name): CHILDREN'S THERAPY WORKS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2653 COUNTY ROAD 74
SAINT CLOUD MN
56301-2205
US

IV. Provider business mailing address

312 4TH ST SW STE 11
WILLMAR MN
56201-3332
US

V. Phone/Fax

Practice location:
  • Phone: 320-229-4069
  • Fax:
Mailing address:
  • Phone: 320-214-7082
  • Fax: 320-235-8059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number102487
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number379363
License Number StateMN

VIII. Authorized Official

Name: MRS. AMY KELLY DANIELSON KRIPPNER
Title or Position: PRESIDENT
Credential: OTRL
Phone: 320-420-4080