Individual
HALEY PAIGE RUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT-R
Contact information
Practice address
8643 W CENTRAL AVE, WICHITA, KS 67212-3614
(316) 204-1259
(888) 595-0755
Mailing address
1055 N 199TH ST W, GODDARD, KS 67052-9131
(316) 204-1259
(888) 595-0755
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T-05323
KANSAS STATE BOARD OF HEALING ARTS
KS
Enumeration date
08/28/2020
Last updated
10/03/2022
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