Individual
KRISTIE MIDDENDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L, BCP, CLC
Contact information
Practice address
6309 MICHAEL DR NE, CEDAR RAPIDS, IA 52411-7982
(954) 312-3449
Mailing address
6309 MICHAEL DR NE, CEDAR RAPIDS, IA 52411-7982
(319) 721-9702
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
00791
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225X00000X
—
FL
Enumeration date
04/13/2020
Last updated
05/04/2020
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