Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 17-03329 | KS |
NPI | 1003334244 |
---|---|
Provider Name | Caitlyn Rask |
First Address | Manhattan, KS 66502 |
Second Address | Manhattan, KS 66502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2017 |
Last Update Date | 08/09/2017 |