Organization
CONNECTED KIDZ, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LESLIE A. JURADO (OCCUPATION THERAPIST)
(803) 620-9702
Entity
Organization
Contact information
Practice address
1803 EBENEZER RD, ROCK HILL, SC 29732-1189
(803) 620-9702
(803) 620-9722
Mailing address
1803 EBENEZER RD, ROCK HILL, SC 29732-1189
(803) 620-9702
(803) 620-9722
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP9395
—
SC
05
—
TH1347
—
SC
Enumeration date
10/24/2019
Last updated
04/10/2020
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