Organization
SKILL BUILDERZ PEDIATRIC THERAPY, LLC
Active
Organization
SKILL BUILDERZ PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA K MITTENESS MOT, OTR/L, BCBA (OWNER)
(701) 330-8009
Entity
Organization
Contact information
Practice address
4133 IOWA ST STE 210, ALEXANDRIA, MN 56308-3316
(701) 330-8009
Mailing address
4133 IOWA ST STE 210, ALEXANDRIA, MN 56308-3316
(701) 330-8009
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/09/2018
Last updated
11/17/2022
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