Individual
MRS. CAROL YVONNE PETTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
14631 FLOYD ST, OVERLAND PARK, KS 66223-2244
(913) 488-9848
(913) 897-0248
Mailing address
14631 FLOYD ST, OVERLAND PARK, KS 66223-2244
(913) 488-9848
(913) 897-0248
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-00006
KS
Other
Enumeration date
12/08/2011
Last updated
12/08/2011
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