Organization
KIDPRO THERAPIES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER L WILD OTR (PRESIDENT)
(772) 260-9499
Entity
Organization
Contact information
Practice address
10702 SW ELSINORE DR, PORT SAINT LUCIE, FL 34987-2149
(772) 260-9499
Mailing address
8651 SW CRUDEN BAY CT, STUART, FL 34997-4206
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
830086100
—
FL
Enumeration date
04/05/2007
Last updated
07/18/2022
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