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General NPI Number Information
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NPI Number | 1609184704
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Entity Type | Organization
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Legal Business Name | CONNECT THE DOTS THERAPY, P.C.
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Dates
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Enumeration Date | 09/22/2010
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Last Update Date | 09/22/2010
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Provider Practice Location Address
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Address Line | 160 S WATER ST UNIT B
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City | BATAVIA
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State | IL
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Zip | 60510-2447
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Country | US
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Telephone | 630-399-2244
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 153
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City | BATAVIA
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State | IL
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Zip | 60510-0153
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OTR/L
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Name | MRS. CARRIE KRANZ
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Credential |
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Telephone | 630-399-2244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 056006476
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License Number State | IL
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