Organization
LITTLE LIGHTS PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISANN MILLER OTR/L (OWNER)
(701) 751-0410
Entity
Organization
Contact information
Practice address
1615 CAPITOL WAY, BISMARCK, ND 58501-2218
(701) 751-0410
Mailing address
1615 CAPITOL WAY, BISMARCK, ND 58501-2218
(701) 751-0410
(855) 834-5421
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
01/03/2018
Last updated
11/17/2022
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