Jacey Anderson, COTA

Individual provider Active NPI Occupational Therapy Assistant · Hesston, KS

NPI 1194035246 · NPPES record last updated Oct 7, 2010

Key facts

NPI
1194035246
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
18-00690 (KS)
Practice address
200 W Cedar St
Hesston, KS 67062-8100
Phone
(620) 327-4155
NPI assigned
Oct 7, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
18-00690KSMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 18-00690 KS Yes

Addresses

Primary practice location

200 W Cedar St
Hesston, KS 67062-8100

Mailing address

200 W Cedar St
Hesston, KS 67062-8100
Phone (620) 327-4155

Other providers in Hesston, KS

All providers in Hesston, KS · Occupational Therapy Assistant in Kansas

Sources for this page

Verify at the official NPI Registry.