Tymber Jacques

Individual provider Active NPI Occupational Therapy Assistant · South Hutchinson, KS

NPI 1982153540 · NPPES record last updated Sep 23, 2016

Key facts

NPI
1982153540
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
18-01154 (KS)
Practice address
600 W Blanchard Ave
South Hutchinson, KS 67505-1526
Phone
(620) 663-7175
NPI assigned
Sep 23, 2016
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
18-01154KSMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 18-01154 KS Yes

Addresses

Primary practice location

600 W Blanchard Ave
South Hutchinson, KS 67505-1526

Mailing address

301 E Avenue B
Mount Hope, KS 67108-8808

Other providers in South Hutchinson, KS

All providers in South Hutchinson, KS · Occupational Therapy Assistant in Kansas

Sources for this page

Verify at the official NPI Registry.