Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 18-01495 | KS |
N | 224Z00000X | Occupational Therapy Assistant | 2018004645 | MO |
NPI | 1023504776 |
---|---|
Provider Name | Hunter V Cleland |
First Address | Olathe, KS 66062-4129 |
Second Address | Kansas City, MO 64145-1764 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2018 |
Last Update Date | 05/07/2018 |