Individual
KRISTEN JESSICA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3500 N ROCK RD STE 101, WICHITA, KS 67226-1341
(316) 440-3316
(888) 965-6885
Mailing address
3500 N ROCK RD STE 101, WICHITA, KS 67226-1341
(316) 440-3316
(888) 965-6885
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
T-04882
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T-04882
STATE OF KANSAS LICENSE
KS
Enumeration date
04/17/2018
Last updated
04/17/2018
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