Individual
SHANDA KOETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 LINCOLN ST, EMPORIA, KS 66801-2449
(162) 034-3221
(620) 342-1021
Mailing address
1000 LINCOLN ST, EMPORIA, KS 66801-2449
(162) 034-3221
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13260
BSRB
KS
Enumeration date
10/13/2023
Last updated
10/13/2023
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