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General NPI Number Information
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NPI Number | 1053513325
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Entity Type | Individual
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Provider Name | ROXANNE PEREZ OTA
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Gender | Female
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3220 SW ALBRIGHT DR
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City | TOPEKA
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State | KS
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Zip | 66614-4707
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Country | US
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Telephone | 615-896-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 304 NE GRATTAN ST
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City | TOPEKA
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State | KS
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Zip | 66616-1229
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Country | US
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Telephone | 785-233-4729
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 18-00306
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License Number State | KS
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