Provider Demographics
NPI:1912755794
Name:WITHROW, KYLEE ANNE (OTD)
Entity type:Individual
Prefix:
First Name:KYLEE
Middle Name:ANNE
Last Name:WITHROW
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5020 S TENNIS LN STE 6
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2231
Mailing Address - Country:US
Mailing Address - Phone:605-961-7250
Mailing Address - Fax:
Practice Address - Street 1:5020 S TENNIS LN STE 6
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2231
Practice Address - Country:US
Practice Address - Phone:605-961-7250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics