Organization
KALEIDOSCOPE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROBYN RAE SOMRATY OTR (OWNER)
(618) 977-4683
Entity
Organization
Contact information
Practice address
486 GLEN CROSSING RD, GLEN CARBON, IL 62034-1500
(618) 977-4683
Mailing address
486 GLEN CROSSING RD, GLEN CARBON, IL 62034-1500
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
IL
Other
Enumeration date
02/18/2007
Last updated
08/22/2020
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