Healthcare Provider Details

I. General information

NPI: 1760144711
Provider Name (Legal Business Name): CONNECTING KIDZ PEDIATRIC THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 10/07/2021
Certification Date: 09/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74007 DRIVE 424 A
ELWOOD NE
68937
US

IV. Provider business mailing address

74007 DRIVE 424 A
ELWOOD NE
68937
US

V. Phone/Fax

Practice location:
  • Phone: 308-455-9025
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: AMY SCHNACKER
Title or Position: OCCUPATIONAL THERAPIST/OWNER
Credential: OTR/L
Phone: 308-455-9025