Pamela Rae Backes, MOT OTR/L

Individual provider Active NPI Occupational Therapist · Shawnee, KS

NPI 1992054027 · NPPES record last updated Sep 5, 2012

Key facts

NPI
1992054027
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
17-01205 (KS)
Practice address
4409 Aminda St
Shawnee, KS 66226-2455
Phone
(913) 441-0284
NPI assigned
Sep 5, 2012
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)
Yes

State licenses

LicenseStateTypeSpecialty
17-01205KSMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 17-01205 KS Yes

Addresses

Primary practice location

4409 Aminda St
Shawnee, KS 66226-2455

Mailing address

4409 Aminda St
Shawnee, KS 66226-2455
Phone (913) 441-0284

Other providers in Shawnee, KS

All providers in Shawnee, KS · Occupational Therapist in Kansas

Sources for this page

Verify at the official NPI Registry.