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General NPI Number Information
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NPI Number | 1194553081
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Entity Type | Organization
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Legal Business Name | THRIVEKIDS OT PLLC
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Dates
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Enumeration Date | 07/23/2024
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 6699 WINDRIDGE CIR
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City | LEXINGTON
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State | OK
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Zip | 73051-9468
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Country | US
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Telephone | 405-974-1412
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Fax |
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Provider Business Mailing Address
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Address Line | 6699 WINDRIDGE CIR
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City | LEXINGTON
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State | OK
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Zip | 73051-9468
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Country | US
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Telephone | 405-974-1412
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KELLY RABE
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Credential | COTA/L
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Telephone | 405-974-1412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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