MEDICARE: VERONICA HERRERA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	1800409	KS

General Provider Information

NPI Number	:	1104264951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA HERRERA

Provider Business Mailing Address
First Line	:	1201 CONARD AVE
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-3917
Country	:	US
Telephone Number	:	620-338-6665
Fax Number	:

Provider Business Practice Location Address
First Line	:	620 E WOOD ST
Second Line	:
City	:	CLEARWATER
State	:	KS
Zip	:	67026-9757
Country	:	US
Telephone Number	:	620-338-6665
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2013
Last Update Date	:	06/13/2013

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Directions to “ VERONICA HERRERA ” Practice Location

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