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Individual

BAMLAKU KEBEDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTA

Contact information

Practice address
3811 W 52ND ST, ROELAND PARK, KS 66205-1458
(913) 579-8556
Mailing address
977 E NEW LONDON DR, OLATHE, KS 66061-7117
(913) 232-3577

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
470224
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
YBC15K024376
KS
Enumeration date
03/22/2022
Last updated
03/22/2022
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