Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003316555 |
---|---|
Provider Name | Austin Nicole Brown |
First Address | Leawood, KS 66209-2021 |
Second Address | Olathe, KS 66061-6219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2018 |
Last Update Date | 20/02/2018 |