Kiddly Winks Therapeutics, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2002014370 Issued in MO

Legal business name

KIDDLY WINKS THERAPEUTICS, LLC

Practice address

875 N Kingshighway St
Suite B
Cape Girardeau, MO 63701-4315

Phone

(573) 587-6772

NPI assigned

Jul 17, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Carisa G Pursell

Title

Manager

Phone

(573) 587-6772

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279324800000",
    "number": "1053624155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 LAUREL LN",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014108",
            "telephone_number": "573-587-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 N KINGSHIGHWAY ST",
            "address_2": "SUITE B",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014315",
            "telephone_number": "573-587-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDDLY WINKS THERAPEUTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-17",
        "last_updated": "2010-07-17",
        "status": "A",
        "authorized_official_last_name": "PURSELL",
        "authorized_official_first_name": "CARISA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "573-587-6772",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2002014370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.