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NPI Code Detail

MEDICARE: MRS. RITA ANN O'GWIN LSCSW

MEDICARE: MRS. RITA ANN O'GWIN LSCSW
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
11041C0700XClinical Social WorkerLSCSW 4430KS

General Provider Information

NPI Number : 1538462239
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RITA ANN O'GWIN LSCSW
Provider Business Mailing Address
First Line : 917 KANSAS ST
Second Line :
City : LARNED
State : KS
Zip : 67550-2530
Country : US
Telephone Number : 620-285-6598
Fax Number :
Provider Business Practice Location Address
First Line : 1905 19TH ST
Second Line :
City : GREAT BEND
State : KS
Zip : 67530-2502
Country : US
Telephone Number : 620-792-5700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2010
Last Update Date : 04/21/2015

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