Individual
DANIELLE WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3604 N 112TH TER, KANSAS CITY, KS 66109-3445
(316) 807-2000
Mailing address
3604 N 112TH TER, KANSAS CITY, KS 66109-3445
(316) 807-2000
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-01290
KS
Other
Enumeration date
01/16/2017
Last updated
01/16/2017
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