Individual
MS. L. SUSAN HERRMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
10300 W 103RD ST STE 400, OVERLAND PARK, KS 66214-2642
(913) 894-1910
Mailing address
6118 ROBINSON ST, OVERLAND PARK, KS 66202-3053
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18-00330
KS
174400000X
Specialist
2003012171
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18-00330
STATE LICENSE
KS
01
—
2003012171
STATE LICENSE
MO
Enumeration date
05/14/2007
Last updated
07/08/2007
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