Individual
TARA JANAE LITZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT/L, COTA/L
Contact information
Practice address
629 S PLUMMER AVE, CHANUTE, KS 66720-1928
(620) 432-5379
Mailing address
422 S KANSAS AVE, CHANUTE, KS 66720-2107
(620) 212-1825
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
18-01341
KS
225X00000X
Occupational Therapist
Primary
17-03599
KS
225X00000X
Occupational Therapist
T-05144
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17-03599
KANSAS STATE BOARD OF HEALING ARTS
KS
01
—
426052
NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
—
Enumeration date
08/14/2018
Last updated
03/02/2021
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