Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | T02784 | KS |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 17-02684 | KS |
NPI | 1396059192 |
---|---|
Provider Name | Alisa Ann Gabel |
First Address | Wichita, KS 67205-2121 |
Second Address | Wichita, KS 67226-3613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2010 |
Last Update Date | 04/01/2022 |