Individual
MRS. SARA REBECCA BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
12100 W 109TH ST, OVERLAND PARK, KS 66210-1200
(913) 469-4210
Mailing address
7642 HIGH DR, PRAIRIE VILLAGE, KS 66208-3642
(918) 961-0228
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
17-03702
KS
Other
Enumeration date
03/27/2020
Last updated
03/27/2020
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