Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XE0001X | Environmental Modification | 17-03417 | KS |
Y | 225XG0600X | Occupational Therapist - Gerontology | 17-03417 | KS |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 17-03417 | KS |
NPI | 1467038364 |
---|---|
Provider Name | Kayle Sue Eastes |
First Address | Hays, KS 67601-3237 |
Second Address | Ellis, KS 67637-1757 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2021 |
Last Update Date | 22/03/2021 |