Individual
MRS. PRUEKSA CHITTHAM-BLEDSOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3119 W FAIDLEY AVE, GRAND ISLAND, NE 68803-4114
(816) 806-3324
Mailing address
3827 MEADOW WAY TRL, GRAND ISLAND, NE 68803-1557
(816) 806-3324
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2014028928
MO
225X00000X
Occupational Therapist
Primary
2419
NE
Other
Enumeration date
11/19/2014
Last updated
02/02/2022
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