Healthcare Provider Details
I. General information
NPI: 1760237143
Provider Name (Legal Business Name): PEDIATRIC CONNECTIONS OCCUPATIONAL THERAPY SERVICES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/19/2024
Last Update Date: 04/19/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
455 SW GOLF PARK BVD
TOPEKA KS
66605
US
IV. Provider business mailing address
7235 W 162ND TER
OVERLAND PARK KS
66085-8238
US
V. Phone/Fax
- Phone: 913-257-5808
- Fax: 844-270-5777
- Phone: 913-257-5808
- Fax: 844-270-5777
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QD1600X |
| Taxonomy | Developmental Disabilities Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DEANA
LYNN
LESHER
Title or Position: OWNER
Credential:
Phone: 913-257-5808