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NPI Code Detail

MEDICARE: KAYLYN JO SHUMATE COTA/L

MEDICARE: KAYLYN JO SHUMATE COTA/L
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
1224Z00000XOccupational Therapy Assistant18-01494KS

General Provider Information

NPI Number : 1669155354
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLYN JO SHUMATE COTA/L
Provider Business Mailing Address
First Line : 650 CR B
Second Line :
City : MINNEOLA
State : KS
Zip : 67865-6550
Country : US
Telephone Number : 620-255-0992
Fax Number :
Provider Business Practice Location Address
First Line : 2160 ZINNIA LN
Second Line :
City : LIBERAL
State : KS
Zip : 67901-2042
Country : US
Telephone Number : 620-624-3831
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2023
Last Update Date : 08/09/2023

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Directions to “ KAYLYN JO SHUMATE COTA/L” Practice Location

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