=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114756764
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | OKSANA ROSE LITARDO OTD, OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/31/2024
-----------------------------------------------------
Last Update Date | 07/31/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 634 SW MULVANE ST STE 404
-----------------------------------------------------
City | TOPEKA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66606-1678
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-295-8045
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9314 REEDER AVE APT 4
-----------------------------------------------------
City | OVERLAND PARK
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66214-1841
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-314-9104
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 17-04096
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------