Healthcare Provider Details

I. General information

NPI: 1770815896
Provider Name (Legal Business Name): CHANDA LOUISE GARDNER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2010
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 N ST FRANCIS ST FL 6
WICHITA KS
67214-3821
US

IV. Provider business mailing address

6205 W KOLLMEYER CT
WICHITA KS
67205-5278
US

V. Phone/Fax

Practice location:
  • Phone: 316-261-8303
  • Fax: 316-268-5505
Mailing address:
  • Phone: 316-519-2426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number17-02561
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: