Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 17-0458 | KS |
NPI | 1003138827 |
---|---|
Provider Name | Terri Little |
First Address | Manhattan, KS 66502-4556 |
Second Address | Manhattan, KS 66502-4556 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2010 |
Last Update Date | 20/02/2010 |