| NPI | 1629224860 |
|---|---|
| Doing Business As | PRAIRIE THERAPY |
| Entity Type | Organization |
| Authorized Contact | KELLY LON DREVECKY Owner/Practicioner 1701-720-5355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: ND 612) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: ND 612) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2008-08-07 |