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Individual

BROOKE DANAY MUNDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1502 E CENTENNIAL DR, PITTSBURG, KS 66762-6718
(620) 235-0020
Mailing address
2251 JAYHAWK RD, FORT SCOTT, KS 66701-8716
(620) 205-6203

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
18-0187
KS
224Z00000X
Occupational Therapy Assistant
Primary
2021011411
MO

Other

Enumeration date
08/02/2023
Last updated
08/02/2023
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