Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003462847 |
---|---|
Provider Name | Alicia M Pille |
First Address | Wichita, KS 67202-3017 |
Second Address | Lenexa, KS 66214-9836 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2019 |
Last Update Date | 16/08/2019 |