Jill Cannon, COTA

Individual provider Active NPI Occupational Therapy Assistant · Overland Park, KS

NPI 1700524428 · NPPES record last updated May 23, 2022

Key facts

NPI
1700524428
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
18-01845 (KS)
Practice address
7819 Conser PL
Overland Park, KS 66204-2820
Phone
(913) 789-9900
NPI assigned
May 23, 2022
Sex
Female
Sole proprietor
No

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
18-01845KSMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 18-01845 KS Yes

Addresses

Primary practice location

7819 Conser PL
Overland Park, KS 66204-2820

Mailing address

7819 Conser PL
Overland Park, KS 66204-2820
Phone (913) 789-9900

Electronic endpoints

TypeEndpointUseAffiliation
Other URL medicalrecords@mindsmatterllc.com Health Information Exchange (HIE)

Other providers in Overland Park, KS

All providers in Overland Park, KS · Occupational Therapy Assistant in Kansas

Sources for this page

Verify at the official NPI Registry.