Skill Builderz Pediatric Therapy, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

SKILL BUILDERZ PEDIATRIC THERAPY, LLC

Practice address

4133 Iowa St Ste 210
Alexandria, MN 56308-3316

Phone

(701) 330-8009

NPI assigned

Oct 9, 2018

Organization subpart

No

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

Authorized official

Name

Lisa K Mitteness, MOT, OTR/L, BCBA

Title

Owner

Phone

(701) 330-8009

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1144795717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4133 IOWA ST STE 210",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083316",
            "telephone_number": "701-330-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4133 IOWA ST STE 210",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083316",
            "telephone_number": "701-330-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKILL BUILDERZ PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-09",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "MITTENESS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-330-8009",
        "authorized_official_credential": "MOT, OTR/L, BCBA"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destiny Sieracki
• Ryan Silbernick, D.C.
• Trudy D Sirany, MD
• Jennifer Lorraine Skaden
• Samantha Skarka
• Larry Elroy Sletten
• Jason M Slivnik, MS, ATC
• Laura Sloan, OTR/L
• Heidi L Smith, PAC
• Rachel Anne Smith

• Multi-Specialty Clinic/Center in Alexandria, MN
• Providers in Alexandria, MN by specialty
• Multi-Specialty Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.