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Individual

ERIN KELLIE JEFFRESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
3500 N ROCK RD, BUILDING 2200, STE 101, WICHITA, KS 67226
(316) 440-3316
Mailing address
731 N KLEIN CIR, DERBY, KS 67037-7011
(316) 440-9617
(316) 440-9619

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-00781
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18-00781
KANSAS BOARD OF HEALING ARTS
KS
Enumeration date
07/10/2014
Last updated
11/27/2023
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