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Organization
SUCCESSFUL KIDS
Active
Organization
SUCCESSFUL KIDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA ANN BRAATEN-HEIDENREICH OTR/L (OWNER)
(815) 685-4608
Entity
Organization
Contact information
Practice address
12115 S WOLF DR, PLAINFIELD, IL 60585-9755
(815) 685-4608
Mailing address
12115 S WOLF DR, PLAINFIELD, IL 60585-9755
(815) 685-4608
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IL
Other
Enumeration date
09/21/2006
Last updated
08/22/2020
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