Individual
ANDREA MEGAN SOUTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
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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