Provider Demographics
NPI:1023296068
Name:KIDS ABILITIES, INC
Entity type:Organization
Organization Name:KIDS ABILITIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:E
Authorized Official - Last Name:SARGENT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:651-451-3016
Mailing Address - Street 1:490 HIGHWAY 96 W
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-1960
Mailing Address - Country:US
Mailing Address - Phone:651-451-3016
Mailing Address - Fax:
Practice Address - Street 1:490 HIGHWAY 96 W
Practice Address - Street 2:SUITE 300
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-1960
Practice Address - Country:US
Practice Address - Phone:651-451-3016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8285235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty