# FUNCTIONAL INTEGRATED THERAPY, LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Functional Kids Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477640613
- **Authorized official:** KRISTI KAY WORRELL OTR/L (OWNER/OPERATOR)
- **Authorized official phone:** (651) 770-8884

## Contact information

- **Practice address:** 2495 MAPLEWOOD DRIVE, SUITE 313, MAPLEWOOD, MN 55109-1913
- **Practice address phone:** (651) 770-8884
- **Practice address fax:** (651) 770-8151
- **Mailing address:** 2495 MAPLEWOOD DRIVE, SUITE 313, MAPLEWOOD, MN 55109-1913
- **Mailing address phone:** (651) 770-8884
- **Mailing address fax:** (651) 770-8151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | 100591 | MN | Yes |

## Other

- **Enumeration date:** 10/09/2006
- **Last updated:** 03/31/2009