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Organization

KIDSPACE LLC

Active
Other names
KIDSPACE, Briana M. Harris, OTD, OTR/L, COULEE KIDSPACE
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRIANA M HARRIS OTD, OTR/L (OWNER, OPERATOR, OTR/L)
(608) 234-8119
Entity
Organization

Contact information

Practice address
531 MAIN ST, LA CROSSE, WI 54601-4022
(608) 812-8787
Mailing address
531 MAIN ST, LA CROSSE, WI 54601-4022
(608) 812-8787

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100153371
WI
Enumeration date
01/27/2022
Last updated
02/07/2022
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