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Individual

ANDREA MEGAN SOUTHARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
5420 W 151ST ST, LEAWOOD, KS 66224-8713
(913) 219-5696
Mailing address
13141 S SUMMIT ST, OLATHE, KS 66062-8804
(913) 660-6883

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
2014035222
MO
225X00000X
Occupational Therapist
Primary
225XP0200X
Pediatric Occupational Therapist
17-03037
KS

Other

Enumeration date
05/14/2015
Last updated
04/04/2023
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