Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 18-01464 | KS |
NPI | 1013575109 |
---|---|
Provider Name | Rebecca Lynn Winter |
First Address | Augusta, KS 67010-2270 |
Second Address | El Dorado, KS 67042-3751 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2019 |
Last Update Date | 03/06/2019 |