Individual
MINDY HAZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10300 W 103RD ST STE 300, OVERLAND PARK, KS 66214-2658
(913) 894-1910
Mailing address
12108 W 50TH CT, SHAWNEE, KS 66216-1362
(913) 268-4394
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
17-02302
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17-02302
OT LICENSE
KS
Enumeration date
09/06/2007
Last updated
09/06/2007
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