Individual
MRS. ANGELA PETITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
730 1ST TER, LANSING, KS 66043-1704
(913) 683-3914
Mailing address
16536 HILDEBRANDT RD, LEAVENWORTH, KS 66048-8465
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
17-02238
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0587004
NATIONAL OTREGISTRATION
—
01
—
17-02238
LICENSE NUMBER
KS
Enumeration date
04/16/2007
Last updated
07/08/2007
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